Clinical Analysis Of 145 Cases Of Spontaneous Bacterial Peritonitis

Objective:To evaluate clinical manifestation,laboratory tests,distribution of bacteria, treatment and prognosis of spontaneous bacterial peritonitis.And to improve the diagnostic and treatment level of spontaneous bacterial peritonitis.Methods:In a cohort of 145 patients who hospitalized in our hospital during period of 2007-2008 and who performed blood routine and biochemical tests,ascites routine tests and cultures,we conducted a retrospective study to examine clinical features,laboratory findings and management of these patients.All patients were given supportive therapy including plasma,albumin infusion,and antibiotic therapy according to clinical experience and drug sensitivity results. Results:Among these study subjects the proportion of patients with cirrhosis were 89.66%(n=130),cirrhosis caused by hepatitis B were 53.10%(n=77),cirrhosis caused by hepatitis C were 18.62%(n=27).The number of patients suffer from abdominal pain were 61(42.06%),abdominal distention were 76(52.41%),tenderness were 65(44.82%),rigidity and rebound tenderness were uncommon.White blood cell counts over 10×10~9/L were 57(22.52%),neutrophil percentage over 70%were 102,serum albumin level less than 30g/L were 91.Ascites white cell counts over 250×10~6/L were 86(71.2%),polymorphonuclear cell percentage more than 25%were 95(78.5%),albumin level over 30g/L were 24(19.83%). Ascites culture positive rate were 24.29%,among them gram stain negative(G~-) bacteria were 65.38%,gram stain positive(G~+)were 34.61%.After treatment,cured patients were 51(35.17%),improved patients were 70(48.27%),died patients were 24(16.55%).Patients died from hepato-renal syndrome were 17(70.83%).Conclusion:1.Cirrhosis caused by hepatitis B were the most common cause of SBP.2.The symptoms and signs of SBP were atypical.3.Ascites white cell counts and polymorphonuclear cell percentage have high significance for diagnosis.4.Ascites culture positive rate were low.Bacterium coli were the main positive bacteria.5.Hepato-renal syndrome was the most severe fetal complication of SBP.6.Early diagnosis and proper combined use of antibiotics according to culture increase therapeutic effects and improve patient's prognosis.