Kachintorn U, Chainuvati T, Chinapak O, Plengvanit U
Ann Acad Med Singap. 1986 Apr;15(2):221-6.
During a two-year period, 30 patients with spontaneous bacterial peritonitis were documented. All patients had ascites and 70% were alcoholic cirrhosis. Fever and abdominal pain were the most frequent presenting manifestations (96.66% and 76.66% respectively). Triads of fever, abdominal pain and rebound tenderness were found in 40%. A third had hepatic encephalopathy and decreased bowel sound. Ascitic fluid was transudate. Positive ascitic fluid culture and blood culture were obtained in 40% and 59% respectively, and three quarters were due to gram negative enteric bacilli. There was no significant statistic correlation among the result of ascitic fluid gram's stain and ascitic fluid culture, and of ascitic fluid culture and blood culture. The clinical and laboratory findings of patients with positive and negative ascitic fluid culture were similar. Significant increased mortality was found in patients who had hepatic encephalopathy, hypotension, increased bilirubin level and serum creatinine. The over all mortality was 33.33%. We recommend abdominal paracentesis in every cirrhotic patients with ascites who were admitted into hospital.
在两年期间，记录了30例自发性细菌性腹膜炎患者。所有患者均有腹水，70%为酒精性肝硬化。发热和腹痛是最常见的表现（分别为96.66%和76.66%）。40%的患者出现发热、腹痛和反跳痛三联征。三分之一的患者有肝性脑病且肠鸣音减弱。腹水为漏出液。腹水培养阳性和血培养阳性分别为40%和59%，四分之三是由革兰氏阴性肠道杆菌引起的。腹水革兰氏染色结果与腹水培养结果之间，以及腹水培养结果与血培养结果之间均无显著统计学相关性。腹水培养阳性和阴性患者的临床及实验室检查结果相似。肝性脑病、低血压、胆红素水平升高和血清肌酐升高的患者死亡率显著增加。总体死亡率为33.33%。我们建议对每一位入院的肝硬化腹水患者进行腹腔穿刺术。
