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目的探讨肝硬化并发自发性腹膜炎腹水培养的病原菌及耐药性并进行分析。方法本院2005年1月至2009年1月住院的肝硬化并发自发性细菌性腹膜炎242例患者腹水病原菌培养及药敏试验观察结果。结果42例腹水培养的阳性病原菌120株,阳性率为49.58%。G-杆菌占73.7%,G+球菌占15.9%。进行药敏试验,未出现耐药菌株7株(5.83%),产生耐药菌株113株(94.17%)。结论自发性腹膜炎早期诊断,及时足量地使用有效的抗生素治疗是改善晚期肝病患者预后的主要因素。用药应遵循早期、足量、联合、广谱、避免肝肾毒性的原则,正确合理和科学地使用抗菌药物,延缓细菌耐药性的产生。
Objective To investigate the pathogenic bacteria and drug resistance of cirrhosis complicated with spontaneous peritonitis ascites culture and analyze. Methods The hospital from January 2005 to January 2009 hospitalized patients with cirrhosis of spontaneous bacterial peritonitis in 242 patients with ascites pathogen culture and drug susceptibility test results. Results 120 cases of positive pathogens were cultured in 42 cases of ascites, the positive rate was 49.58%. G-bacilli accounted for 73.7%, G + cocci accounted for 15.9%. Seven drug-resistant strains (5.83%) did not appear, and 113 strains (94.17%) were drug-resistant strains. Conclusion The early diagnosis of spontaneous peritonitis, timely and adequate use of effective antibiotic treatment is to improve the prognosis of patients with advanced liver disease is the main factor. Medication should follow the early, adequate, combined, broad-spectrum, to avoid the principle of liver and kidney toxicity, correct and scientific use of antimicrobial agents, delay the emergence of bacterial resistance.