肝炎后肝硬化自发性细菌性腹膜炎临床分析

【】目的探讨肝炎后肝硬化自发性细菌性腹膜炎（spontaneousbacterialperitonitis，SBP）的诊疗情况及头孢哌酮舒巴坦联合左旋氧氟沙星对SBP的治疗效果。方法对2004年1月-2009年12月收治的54例肝炎后肝硬化SBP患者，应用头孢哌酮舒巴坦联合左旋氧氟沙星给与治疗，并观察分析治疗效果。结果肝炎后肝硬化SBP的临床表现以发热，腹痛为主，具有典型腹膜刺激征的不足半数。外周血白细胞升高者不多见，腹腔积液中白细胞计数、PMN计数和细菌培养是自发性细菌性腹膜炎的重要诊断指标。结论肝炎后肝硬化合并SBP的临床表现不典型。致病菌以G-杆菌为主。在早期诊断、综合治疗的基础上，头孢哌酮舒巴坦联合左旋氧氟沙星对自发性细菌性腹膜炎的治疗效果显著。？【Abstract】ObjectiveToevaluatethediagnosisandtreatmentofpost-hepatitiscirrhosiscomplicatedwithspontaneousbacterialperitonitis(SBP)casesandtheefficacyofcefoperazoneandsulbactamcombinedwithlevofloxacininthetreatmentofcirrhoticpatientswithSBP.MethodsFromJanuary2004toDecember2009,theclinicaldatafrom54casesofSBPaftercirrhosiswereanalyzed.Thepatientsunderwentthetreatmentofcefoperazonesulbactamcombinedwithlevofloxacin.Thetherapeuticeffectwasobserved.ResultsThemainclinicalmanifestationswerefeverandabdominalpain,andabouthalfofthepatientshadthetypicalperitonealirritation.Onlyafewpatientshadelevatedperipheralwhitebloodcells(WBC).TheWBCcount,abdominaleffusionpolymorphonuclearcytecountandbacteriacultivationweretheindexesofdiagnosisofSBP.ConclusionTheclinicalfeaturesofpost-hepatitiscirrhosiscomplicatedwithSBParenottypical.ThemainpathogenicbacteriaisG-bacilli.Intheearlydiagnosisandtreatment,cefoperazonesulbactamcombinedwithlevofloxaciniseffective.？