腹水外观清晰能否排除自发性细菌性腹膜炎？
Can clear ascitic fluid appearance rule out spontaneous bacterial peritonitis?
作者信息
Chinnock Brian, Hendey Gregory W
机构信息
Department of Emergency Medicine, UCSF-Fresno Medical Education Program, Community Regional Medical Center, Fresno, CA 93701, USA.
出版信息
Am J Emerg Med. 2007 Oct;25(8):934-7. doi: 10.1016/j.ajem.2007.02.009.
OBJECTIVE
The objective of the study was to determine the sensitivity and specificity of abnormal ascitic fluid appearance in the detection of spontaneous bacterial peritonitis (SBP), as a sensitivity approaching 100% could exclude SBP if the fluid is clear.
METHODS
We performed a retrospective review of all ascitic fluid samples sent for cell count over a 4-year period. Spontaneous bacterial peritonitis was defined as an absolute neutrophil count of more than 250 cells/mm3 or a positive culture. Abnormal fluid appearance was defined as hazy, cloudy, or bloody.
RESULTS
There were 916 ascitic fluid samples analyzed during the study period. Eighteen percent of samples had a clear appearance, whereas 82% were abnormal. Abnormal ascitic fluid appearance had a sensitivity of 98.1% (95% confidence interval, 95.3%-99.5%) and a specificity of 22.7% (95% confidence interval, 19.4%-26.3%) in the detection of SBP.
CONCLUSIONS
Abnormal fluid appearance has a high sensitivity for the detection of SBP. Thus, clear fluid might safely exclude SBP.
目的
本研究的目的是确定腹水外观异常在检测自发性细菌性腹膜炎（SBP）中的敏感性和特异性，因为如果腹水清澈，敏感性接近100%则可排除SBP。
方法
我们对4年内送检进行细胞计数的所有腹水样本进行了回顾性分析。自发性细菌性腹膜炎定义为绝对中性粒细胞计数超过250个细胞/mm³或培养阳性。异常腹水外观定义为浑浊、 cloudy或血性。
结果
研究期间共分析了916份腹水样本。18%的样本外观清澈，而82%的样本外观异常。异常腹水外观在检测SBP中的敏感性为98.1%（95%置信区间，95.3%-99.5%），特异性为22.7%（95%置信区间，19.4%-26.3%）。
结论
异常腹水外观对SBP的检测具有较高的敏感性。因此，清澈的腹水可能可以安全地排除SBP。
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