Clinical Analysis Of Spontaneous Bacterial Peritonitis In Liver Cirrhosis

Objective : To investigate the risk factor ,diagnosis and treatment of Spontaneous bacterial peritonitis in cirrhotic patients.Patients and Methods : The clinical data of 36 patient with liver cirrhosis complicated by SBP in the Gastrointestinal Department of Sir Run Run Shaw Hospital affiliated to Zhejiang University from Jan 2004 to Jan 2006 were collected, and such as predisposing factor , clinical manifestation , laboratory examination, bacterial culture , treatment and turnover were analyzed in retrospective.Result: Twenty-two patients had predisposing factor, and gastrointestinal hemorrhage was the very common predisposing factor. Typical manifestation of Peritonitis were found Only in 6 patients. Abdominaldistention was the very common clinical manifestation. Complication such as hepatic encephalopathy, gastrointestinal hemorrhage , pulmonary infection, disorder of dielectric urinary tract infection and etc. were found in 15 patients . Only 22 patients had high leukocyte count . The patient distributed into Child Pugh A, B and C were 16.7%, 41.2% and 41.2%. Total protein concentration in ascites were 6.32±4.65g/L. Five kinds of different bacterium were found in 9 ascitic fluid. Patients were treated with cefotaxime, ceftriaxone, Levofloxacin and other antibiotics separately, some of them treat with albumin and/or microeclogial modulator. Thirty patients were responsive to therapy.Conclusion : SBP was the common and serious complication for cirrhotic patient, especially for those in later stage . It can not be easily diagnosed only by clinical manifestation for usually lacking typical manifestation. Ascites examination was the most effective and objective method for the diagnose of SBP . All patient suspected of SBP should receive ascites examination if without counterindication of abdominal paracentesis. The death rate of SBP was high but can be reduced if SBP were found earlier and treated properly.