肝硬化腹水并发自发性腹膜炎的相关危险因素探讨.docVIP

2014-1-24主任加工版 肝硬变腹水并发自发性腹膜炎的相关危险因素探讨 余斌斌 （成都市第六人民医院，四川 成都 610051） [摘要]目的：探讨肝硬变腹水患者并发自发性腹膜炎(SBP)的危险因素。方法：98例肝硬变患者的临床资料，分为SBP组和非SBP组，对其临床资料进行回顾性分析，并行logistic回归分析Child-pugh分级，糖尿病史等方面有显著性差异(P＜005)，而年龄、性别、肝硬变病因、血小板数、是否合并肝性脑病等因素无显著性差异(P＞005)。经多因素Logistic回归分析SBP病史、血清白蛋白、血清总胆红素是肝硬变腹水并发SBP的独立影响因素。结论：既往SBP病史、血清白蛋白、血清总胆红素3者可能是肝硬变腹水患者并发SBP的独立危险因素，需加以重视，并积极采取防治措施。 [关键词]肝硬变；自发性腹膜炎；危险因素 [中图分类号]R [文献标志码]A doi:10.11851/j.issn.1673-1557.2014.01.0 Analysis of the Risk Factors on Spontaneous Bacterial Peritonitis in Cirrhotic Patients with Ascities Yu Binbin (Chengdu No.6 People’s Hospital，Chengdu 610051,China) [Abstract]Objective:To analyse the risk factors of spontaneous bacterial peritonitis(SBP)in patients with liver cirrhotic and ascites.Methods:The clinical data of 98 patients, in which 38 cases were complicated by SBP(SBP group)and 60 cases were not(non-SBP group),were analyzed retrospectively.Results:There were significant differences in previous history of SBP,the infection in other parts except abdomen,diabetes,total protein in ascitic fluid, gastrointestinal bleeding,Child-Pugh classification,blood Na+,serum TBil,ALB,PT and total cholesterol between the two groups(P＜);and no significant difierences were in sex,age,cause of cirrhosis,PLT and hepatic encephalopathy between the two groups(P＞). Logistic regression analysis showed that Previous history of SBP、TBil、ALB were significant independent factors to the development of SBP(P＜Conclusions:Previous history of SBP、TBil、ALB are independent risk factors of the development of SBP，we should pay more attention and take preventive measures. [Key words]liver cirrhosis;spontaneous bacterial peritonitis;risk factors 自发性细菌性腹膜炎(spontaneous bacterial peritonitis ，SBP)是指在腹腔及邻近组织无感染源(如腹腔脓肿、急性胰腺炎、胆囊炎、肠穿孔等)情况下发生的腹水感染，常见于肝硬变患者。学者Conn于1971年最先使用“自发性细菌性腹膜炎”这一术语[1]。SBP是晚期肝硬变和慢性重症肝炎的严重并发症，是终末期肝病的重要死亡原因之一。失代偿期肝硬变患者其发生率为10%～47%[2]。据报道，就算在目前强有力支持治疗下，肝硬变住院患者合并SBP的发生率仍为10%～30%[3]，选择2001年1月至2011年l2月我院消化内科住院98例肝硬变并腹水患者，现对其进行回顾性研究。 1 对象与方法