腹腔置管灌洗联合腹腔注射抗生素治疗肝硬化自发性腹膜炎的临床研究

摘要/Abstract

摘要： 目的探讨腹腔置管灌洗联合腹腔注射抗生素治疗肝硬化自发性腹膜炎(SBP)的临床疗效。方法选取2016年6月至 2019年6月我院收治的肝硬化合并SBP患者73例为研究对象,随机分为治疗组和对照组。对照组给予静滴抗生素治疗,治疗组在对照组的基础上给予腹腔置管灌洗联合腹腔注射抗生素治疗,疗程均为14天。观察两组患者治疗后发热、腹痛、腹胀、腹部压痛、反跳痛等症状及体征的变化,记录治疗前后肝功能指标:丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TBil)和炎症指标:白细胞计数(WBC)、降钙素原(PCT)、C反应蛋白(CRP)变化情况,以及临床疗效。结果治疗组患者临床症状、体征的缓解时间,肝功能、炎症因子的改善程度,以及治疗的总有效率、显效率、无效率,均较对照组更好,差异有统计学意义(P<0.05)。结论腹腔置管灌洗联合腹腔注射抗生素可明显缓解肝硬化SBP临床症状、体征,改善肝功能及炎症指标,提高治疗治疗有效率,具有显著的临床疗效。

关键词: 腹腔置管灌洗, 腹腔注射, 肝硬化, 自发性腹膜炎

Abstract: Objective To investigate the clinical effect of intraperitoneal catheterization and lavage combined with intraperitoneal injection of antibiotics in the treatment of spontaneous peritonitis (SBP) of liver cirrhosis.Methods Seventy-three patients with cirrhosis and SBP from June 2016 to June 2019 in our hospital were randomly divided into a treatment group and a control group. The control group was treated with intravenous drip infusion of antibiotics, while the treatment group was treated with intraperitoneal catheterization and lavage combined with intraperitoneal injection of antibiotics on the basis of the control group. The course of treatment was 14 days. The symptoms and signs (fever, abdominal pain, abdominal distention, abdominal tenderness and rebound pain, etc) were observed before and after treatment. The liver function indexes (alanine aminotransferase, aspartate aminotransferase, total bilirubin) and inflammation indexes (white blood cell count, procalcitonin and C-reactive protein) were recorded before and after treatment.Results In the treatment group, the remission time of clinical symptoms and signs were shorter than the control group (P<0.05). The liver function and inflammatory indexes improved more than the control group (P<0.05). The efficacy rate and total effective rate of the treatment group were higher than those of the control group (P<0.05).Conclusion Intraperitoneal catheterization and lavage combined with intraperitoneal injection of antibiotics can significantly alleviate the clinical symptoms and signs of SBP, and improve the liver function and inflammatory indicators, with high treatment efficacy.

Key words: Peritoneal lavage, Intraperitoneal injection, Cirrhosis, Spontaneous peritonitis

梁栋, 边绪强, 张鼎. 腹腔置管灌洗联合腹腔注射抗生素治疗肝硬化自发性腹膜炎的临床研究[J]. 肝脏, 2021, 26(1): 37-40.

LIANG Dong, BIAN Xu-qiang, ZHANG Din. Clinical study on peritoneal lavage combined with intraperitoneal injection of antibiotics in the treatment of cirrhosis patients with spontaneous peritonitis[J]. Chinese Hepatolgy, 2021, 26(1): 37-40.

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