Ensaroğlu Fatih, Korkmaz Murat, Geçkil Ali Ümit, Öcal Serkan, Koç Bengisu, Yıldız Özgün, Atalay Fatma Büşra, Taş Emine Gül, Haberal Mehmet
From the Department of Gastroenterology, Baskent University Faculty of Medicine, Ankara, Turkey.
Exp Clin Transplant. 2015 Nov;13 Suppl 3:131-6. doi: 10.6002/ect.tdtd2015.P71.
Spontaneous bacterial peritonitis, unless originating from surgery or an intra-abdominal source, is an infection diagnosed by neutrophil counts greater than 250/mm³ in ascites. Spontaneous bacterial peritonitis is the most common infection among patients hospitalized with cirrhosis, with a prevalence of 9% and a risk of development among all patients with cirrhosis within 1 year of 10%. No valid parameters have been defined to predict the mortality related to spontaneous bacterial peritonitis. Unless it is treated, the mortality rate as a result of spontaneous bacterial peritonitis is 50%, and serious complications may arise.
Medical records from 29 patients on the deceased-donor transplant waiting list and receiving treatment at the Başkent University Hospital Gastroenterology Clinic for cirrhotic ascites infection between 1996 and 2013 were analyzed. Demographic information, paracentesis findings, clinical follow-up, and treatment results were reviewed and collected from patient medical records, with data recorded to the research form.
In our patient group, 72.4% were men and the average age was 46.6 years. Most of our patients were at advanced stage, with 55.2% having a Child-Pugh score of C and an average Model for End-Stage Liver Disease score of 17 ± 4.1. We found that 34.5% of the patients received prophylactic treatment for spontaneous bacterial peritonitis, 72.4% received a proton pump inhibitor, and 82.8% had treatment with intravenous albumin support at the time of diagnosis. Albumin treatment showed no effect on mortality. Mortality rate among patients with Child-Pugh score of C was 81.3%.
Existence of chronic renal failure, liver graft surgery, and hepatocellular cancer did not seem to have a significant effect on patient mortality. The albumin treatment protocol showed no significant difference despite common belief among physicians.
自发性细菌性腹膜炎，除非源于手术或腹腔内感染源，是一种通过腹水中性粒细胞计数大于250/mm³诊断的感染。自发性细菌性腹膜炎是肝硬化住院患者中最常见的感染，患病率为9%，所有肝硬化患者在1年内发生该病的风险为10%。尚未确定有效的参数来预测与自发性细菌性腹膜炎相关的死亡率。除非进行治疗，自发性细菌性腹膜炎导致的死亡率为50%，并且可能会出现严重并发症。
分析了1996年至2013年间在巴什肯特大学医院胃肠病诊所接受治疗的29例已故供体移植等待名单上的肝硬化腹水感染患者的病历。从患者病历中回顾并收集人口统计学信息、腹腔穿刺结果、临床随访和治疗结果，并将数据记录到研究表格中。
在我们的患者组中，72.4%为男性，平均年龄为46.6岁。我们的大多数患者处于晚期，55.2%的患者Child-Pugh评分为C级，终末期肝病模型平均评分为17±4.1。我们发现34.5%的患者接受了自发性细菌性腹膜炎的预防性治疗，72.4%的患者接受了质子泵抑制剂治疗，82.8%的患者在诊断时接受了静脉白蛋白支持治疗。白蛋白治疗对死亡率无影响。Child-Pugh评分为C级的患者死亡率为81.3%。
慢性肾衰竭、肝移植手术和肝细胞癌的存在似乎对患者死亡率没有显著影响。尽管医生们普遍认为白蛋白治疗方案有效果，但实际上并没有显著差异。
