Baskol Mevlut, Gursoy Sebnem, Baskol Gulden, Ozbakir Omer, Guven Kadri, Yucesoy Mehmet
Erciyes University School of Medicine, Kayseri, Turkey.
J Clin Gastroenterol. 2003 Nov-Dec;37(5):403-5. doi: 10.1097/00004836-200311000-00011.
The goal of this study is to establish whether 5 days of ceftriaxone treatment was sufficient to cure culture-negative neutrocytic ascites in cirrhotic patients. We studied 50 cirrhotic patients with culture-negative neutrocytic ascites. All were treated with ceftriaxone, 1.0 g IV, twice a day for 5 days. A control paracentesis was performed 48 hours after starting the therapy to assess response to the treatment. A total of 17 demographic, clinical, and laboratory variables were recorded in all cases on the day of diagnosis of CNNA. The mean age of the patients was 57.7 +/- 13.2 years. Thirty-two patients were males and 18 females. The etiology of cirrhosis was hepatitis C virus in 20 patients (40%), hepatitis B virus in 16 patients (32%), cryptogenic in 13 patients (26%), and alcohol abuse in 1 patient (2%). Eighty percent of the patients were in Child-Pugh Class C. Resolution rate of culture-negative neutrocytic ascites on day 5 of treatment was 78%. Hospital mortality in cirrhotic patients with culture negative neutrocytic ascites was 4%. Statistical analysis showed that none of the 13 selected variables as covariates significantly related with the resolution of culture-negative neutrocytic ascites. Five days of ceftriaxone treatment is an adequate therapy for culture-negative neutrocytic ascites.
本研究的目的是确定头孢曲松治疗5天是否足以治愈肝硬化患者的培养阴性中性粒细胞性腹水。我们研究了50例培养阴性中性粒细胞性腹水的肝硬化患者。所有患者均接受头孢曲松治疗，静脉注射1.0 g，每日两次，共5天。在开始治疗48小时后进行对照腹腔穿刺术，以评估治疗反应。在诊断为培养阴性中性粒细胞性腹水当天，所有病例共记录了17项人口统计学、临床和实验室变量。患者的平均年龄为57.7±13.2岁。32例为男性，18例为女性。肝硬化的病因在20例患者（40%）中为丙型肝炎病毒，16例患者（32%）中为乙型肝炎病毒，13例患者（26%）中为隐源性，1例患者（2%）中为酒精滥用。80%的患者属于Child-Pugh C级。治疗第5天培养阴性中性粒细胞性腹水的消退率为78%。培养阴性中性粒细胞性腹水的肝硬化患者的医院死亡率为4%。统计分析表明，作为协变量选择的13项变量中，没有一项与培养阴性中性粒细胞性腹水的消退显著相关。头孢曲松治疗5天是治疗培养阴性中性粒细胞性腹水的一种充分疗法。
