Terg R, Abecasis R, Podestá A, Miguez C, de Glee G, Díaz M
Servicio Hepatología, Instituto Nacional Gastroenterología, Buenos Aires, Argentina.
Acta Gastroenterol Latinoam. 1987;17(1):25-33.
Due to scarce printed information in our country, the incidence regarding spontaneous peritonitis observed during two years in 76 ascites episodes, found in 63 patients with hepatic cirrhosis, is analysed retrospectively. Thirteen patients (17%), showed spontaneous peritonitis and the relationship man-woman was 5 to 1; 70% of the germs found in the ascites fluid was of enteric origin, mainly Escherichia Coli. In three patients the diagnosis was made by both counting the leucocytes and the clinical symptoms, in spite of the negative culture. There were no significant differences in the presence of humoral complications or alterations when patients appeared with sterile ascites and spontaneous peritonitis, but there were differences with the death rate which was 7.9% (5/63), in the former and 38% (5/13), in infected ascites; 80% of the dead patients showed renal deficiency at the end of the evolution and a relationship with the use of aminoglucosides can not be discarded. The search for spontaneous peritonitis in the cirrhotic patient, as a routine, seems to have the same incidence among as, as the one described in the literature.
由于我国印刷资料匮乏,我们对63例肝硬化患者在两年内出现的76次腹水发作中观察到的自发性腹膜炎发病率进行了回顾性分析。13例患者(17%)出现自发性腹膜炎,男女比例为5比1;腹水中发现的70%的细菌来自肠道,主要是大肠杆菌。尽管培养结果为阴性,但有3例患者通过白细胞计数和临床症状做出了诊断。无菌性腹水和自发性腹膜炎患者出现体液并发症或改变的情况没有显著差异,但死亡率存在差异,前者为7.9%(5/63),感染性腹水患者为38%(5/13);80%的死亡患者在病程末期出现肾功能不全,不能排除与使用氨基糖苷类药物有关。对肝硬化患者常规进行自发性腹膜炎的检查,其发病率似乎与文献报道的相同。