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目的:观察不同治疗方案用于重症肝炎和肝硬化并发自发性细菌性腹膜炎患者的实际疗效,探讨该类型患者的治疗方案选择。方法:选择2015年1月至2015年12月我院收治的56例重症肝炎和肝硬化并发自发性细菌性腹膜炎患者,按照不同治疗方案分为观察组(n=32)及对照组(n=24),两组患者均接受常规支持治疗,其中观察组给予3周疗程抗感染治疗,同时进行积极穿刺放腹水操作;对照组给予2周疗程抗感染治疗,不进行穿刺放腹水操作。观察指标包括两组患者血液及腹水白细胞数量变化及随访复发率。结果:观察组患者治疗后血液及腹水白细胞改善程度明显优于对照组,且1年随访复发率显著低于对照组,组间差异具有统计学意义(p<0.05)。结论:足量足疗程抗菌药物及积极穿刺放腹水治疗方案用于重症肝炎和肝硬化并发自发性细菌性腹膜炎的临床治疗,显著提升了疗效,具有较高的临床应用价值,值得进一步临床推广应用。
Objective: To observe the curative effect of different treatment regimens in patients with severe bacterial hepatitis and cirrhosis complicated by spontaneous bacterial peritonitis, and to explore the treatment options in this type of patients. Methods: From January 2015 to December 2015, 56 patients with severe hepatitis and cirrhosis complicated with spontaneous bacterial peritonitis admitted to our hospital were divided into observation group (n = 32) and control group (n = 24). Both groups received routine supportive therapy. The observation group received 3 weeks course of anti-infective treatment and positive puncture ascites operation. The control group received anti-infective therapy of 2 weeks course without puncture ascites operation. Observational indicators include changes in the number of white blood cells and ascites white blood cells and follow-up of patients in both groups. Results: The improvement of blood and ascitic leukocytes in observation group was significantly better than that of control group. The recurrence rate at 1-year follow-up was significantly lower than that of control group. The difference was statistically significant (p <0.05). Conclusion: The full-dose, full-course antimicrobial agents and active puncture ascites therapy are used in the clinical treatment of severe bacterial hepatitis and cirrhosis complicated with spontaneous bacterial peritonitis, which has significantly improved the curative effect and has high clinical value, which is worth further clinical application .