Clinical analysis of spontaneous bacterial peritonitis in patients with end-stage liver disease

Objective To analyze the clinical features of spontaneous bacterial peritonitis(SBP) in patients with end-stage liver disease.Method The clinical signs and symptoms,laboratory test of blood and ascites in patients with cirrhosis,severe hepatitis and primary hepatic carcinoma(PHC) were observed and analyzed.Sufficient antibiotics were given to treat these patients according to the results of culture of ascites and drug sensitive tests of bacteria and the therapeutic effects and prognosis were analyzed.Results 109(20.49%) of 532 cases with end stage liver disease were diagnosed as SBP.In cases with severe hepatitis,cirrhosis and PHC,the incidences of SBP were 46.53%,14.61%,13.33%,respectively;The mortality were 57.44%,7.69% and 30.0%,respectively.The leukocyte count in the peripheral blood was more than 10(10~9/L in 29 patients;The polymorphonuclear leucocytes in differential cell count were more than 70% in 62 patients;21 patients with body temperature above 38℃;Only 19.26% ascites culture were positive;Total effective rate was 66.06%.The mortality in patients with SBP is higher than that without SBP.Conclusions The symptoms and signs of SBP in patients with end-stage liver disease are atypical.These patients often have hypersplenism;the leukocyte count decreases and the ascites culture is often negative in these patients.The leukocyte count and polymorphonuclear neutrophils count in the ascites and peripheral blood should be regarded as main bases in diagnosis of SBP;The incidences of SBP in patients with severe hepatitis is higher than those with cirrhosis and PHC.The mortality of patients with SBP is higher than that without SBP.So the prevention and effective treatment of SBP are very important to improve prognosis of patients with end-stage liver disease.