Jarcuska Peter, Veselíny Eduard, Orolín Martin, Takácová Viktória, Hancová Martina
First Dpt. of Internal Medicine, University Hospital in Kosice, Slovak Republic.
Klin Mikrobiol Infekc Lek. 2004 Aug;10(4):176-80.
To assess the objective incidence of infectious complications in liver cirrhosis, to find out correlation among stage of liver cirrhosis, number of infectious complications and mortality in cirrhotic patients.
93 patients with liver cirrhosis were hospitalized from June 1996 to November 1998 (age: 53,44 I 8,03 years, Child-Pugh score: 11,58 I 2,12). 6 patients were in class B, 87 in class C of Child-Pugh classification. Ascites was found in 81 patients, pleural effusion was found in 14 patients. Chest X-ray, examination of ascites and pleural efussion an urine culture were performed by admission, the other infections were actively screened after clinical signs.
Spontaneous bacterial peritonitis was found in 17 patients (18,28 %), secondary bacterial peritonitis in 5 patients (5,38 %), spontaneous bacteremia in 3 patients (3,23 %), spontaneous bacterial pleuritis in 3 patients (3,23 %), bronchopneumonia and infections of respiratory tract in 22 patients (23,66 %), uro-infection in 69 patients (74,19 %) and the other kinds of infection in 14 patients (15,05 %). Mortality of patients correlates with stage of liver cirrhosis and number of infectious complications.
Infections are common complications in hospitalized cirrhotics. Infectious complications are the most common cause of mortality of cirrhosis, patients with bronchopneumonia, secondary bacterial peritonitis or spontaneous bacterial pleuritis had bad prognosis. Early antibiotic treatment at the base of culture and sensitivity is an optimal therapeutic approach in cirrhotics with infections.
评估肝硬化患者感染性并发症的客观发生率,找出肝硬化分期、感染性并发症数量与肝硬化患者死亡率之间的相关性。
1996年6月至1998年11月,93例肝硬化患者住院治疗(年龄:53.44±8.03岁,Child-Pugh评分:11.58±2.12)。Child-Pugh分级中,6例为B级,87例为C级。81例患者有腹水,14例患者有胸腔积液。入院时进行胸部X线检查、腹水及胸腔积液检查和尿培养,出现临床症状后积极筛查其他感染。
17例患者发生自发性细菌性腹膜炎(18.28%),5例患者发生继发性细菌性腹膜炎(5.38%),3例患者发生自发性菌血症(3.23%),3例患者发生自发性细菌性胸膜炎(3.23%),22例患者发生支气管肺炎及呼吸道感染(23.66%),69例患者发生泌尿系统感染(74.19%),14例患者发生其他类型感染(15.05%)。患者死亡率与肝硬化分期及感染性并发症数量相关。
感染是肝硬化住院患者常见的并发症。感染性并发症是肝硬化患者最常见的死亡原因,发生支气管肺炎、继发性细菌性腹膜炎或自发性细菌性胸膜炎的患者预后较差。根据培养及药敏结果尽早进行抗生素治疗是肝硬化合并感染患者的最佳治疗方法。