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目的探讨老年性失代偿性肝硬变并发自发性腹膜炎临床特点。方法对 62 6例老年性失代偿性肝硬变伴有腹水、严重肝损害及不同程度的脾功能亢进、门脉高压症症候群患者的临床资料进行综合分析。结果其中并发自发性腹膜炎 2 3 5例 (3 7.5 3 % ) ,明显高于文献报道的 19% ,合并腹膜炎者中门脉性肝硬变 13 3例 (5 6.60 % ) ,坏死后肝硬变 5 2例(2 2 .12 % ) ,酒精性肝硬变 19例 (8.0 9% ) ,胆汁性肝硬变 10例 (4.2 5 % ) ,肝硬变合并肝癌 2 1例 (8.93 % )。 2 3 5例中 12 4例曾反复发生感染 ,其诱因较多 ,发生在放腹水 49例 ,应用激素治疗 3 3例 ,慢性肠道感染 5 8例 ,急性肠道感染 3 1例 ,急性上呼吸道感染 10例 ,肺结核 4例 ,其中 5 0例不明原因。发病隐匿 93例 (3 9.5 7% ) ,急性发病 142例 (60 .42 % )。治疗除常规保肝、利尿对症处理外 ,常采用足量、联合应用抗生素静脉或腹腔内注射 ;疗程根据病情而定 ,治愈 75例 (3 1.3 3 % ) ,好转 12 9例 (5 4.89% ) ,无效 3 1例 (13 .19% )。结论急性发病表现感染症状明显。而隐匿发病者除门脉高压症候群外 ,其他感染症状不明显。往往表现为肝硬变腹水治疗效果不佳 ,而且肝功能逐渐恶化 ,腹水检查均属慢性感染。无效者常死于肝性脑病、上消化道出血、肝肾综合征及中
Objective To investigate the clinical features of spontaneous peritonitis in elderly patients with decompensated cirrhosis. Methods A total of 626 elderly patients with decompensated liver cirrhosis with ascites, severe liver damage and varying degrees of hypersplenism and portal hypertension patients with clinical data were analyzed. Results There were 235 cases (37.5%) of spontaneous peritonitis complicated with peritonitis and 13.3 cases (5 6.60%) with peritonitis in cirrhosis with cirrhosis There were 52 cases (22.2%) with alcoholic cirrhosis, 19 (8.09%) with alcoholic cirrhosis, 10 (4.2 5%) with biliary cirrhosis and 21 (8.93%) with cirrhosis and hepatocellular carcinoma. Of the 235 cases, 12 4 cases had recurrent infections with many causes, including 49 cases of ascites, 33 cases of hormone therapy, 58 cases of chronic intestinal infection and 31 cases of acute intestinal infection. Acute Respiratory infections in 10 cases, 4 cases of pulmonary tuberculosis, of which 50 cases of unknown causes. Incidence 93 cases (3 9.57%), acute onset 142 cases (60.42%). In addition to conventional treatment of liver and diuretic symptomatic treatment, often enough, combined with intravenous antibiotics or intraperitoneal injection; course of treatment according to the disease, and cured 75 cases (3 1.3 3%), improved 12 9 cases (5 4.89% , Invalid 3 1 cases (13.19%). Conclusion Acute manifestations showed obvious symptoms of infection. In addition to occult pathogens other than portal hypertension syndrome, other symptoms of infection is not obvious. Often manifested as poor liver cirrhosis treatment, and liver function deteriorating, ascites are chronic infections. Invalid often die of hepatic encephalopathy, upper gastrointestinal bleeding, hepatorenal syndrome and in