腹水浓缩结合抗菌药物对肝硬化并发腹水感染患者实验室指标影响的研究
|
摘要
目的探索腹水浓缩结合抗菌药物对肝硬化并发腹水感染患者实验室指标和疗效的影响。方法选取2015年5月-2017年6月医院接受治疗的152例肝硬化并发腹水感染患者为研究对象,按照随机数表法分为对照组和研究组,对照组采用抗菌药物治疗,研究组在对照组基础上添加腹水浓缩治疗。采集患者血液并检测谷丙转氨酶(ALT)、谷草转氨酶(AST)、尿素氮(BUN)、总胆红素(TBIL)、血肌酐(Scr)等实验室指标。采用肝硬化腹水中西医结合诊疗评价量表对患者疗效进行评价。结果研究组患者治疗后ALT为(41.07±12.11)IU/L,AST为(34.28±10.44)IU/L,BUN为(4.12±1.03)mmol/L,TBIL为(30.47±11.29)μmol/L,Scr为(89.24±17.67)μmol/L,均低于对照组患者ALT(58.13±13.24)IU/L,AST(63.22±13.47)IU/L,BUN(7.13±2.37)mmol/L,TBIL(47.82±13.43)μmol/L,Scr(125.08±27.69)μmol/L(P<0.05)。两组疗效等级资料比较差异无统计学意义,但研究组患者治疗总有效率94.74%(72/76)高于对照组总有效率76.32%(58/76),两组比较差异有统计学意义(χ2=10.417,P<0.001)。结论腹水浓缩结合抗菌药物能够有效降低肝硬化并发腹水感染患者实验室指标水平,治疗效果显著,适合临床推广治疗。
OBJECTIVE To observe the effect of ascites concentration combined with antibiotics on laboratory indexes and curative effects of the liver cirrhosis patients complicated with ascites infection.METHODS A total of 152 liver cirrhosis patients complicated with ascites infection who were treated in the hospital from May 2015 to Jun2017 were recruited as the study objects and randomly divided into the control group and the study group.The control group was treated with antibiotics,while the study group was given the ascites concentration therapy on basis of the treatment of the control group.The blood specimens were collected to detect the laboratory indexes,including alanine aminotransferase(ALT),aspartate aminotransferase(AST),blood urea nitrogen(BUN),total bilirubin(TBIL)and serum creatinine(Scr).The curative effects of the patients were evaluated on the basis of Traditional Chinese Medicine combined with western medicine evaluation scale for liver cirrhosis-induced ascites.RESULTS The levels of ALT,AST,BUN,TBIL and Scr of the study group were respectively(41.07±12.11)IU/L,(34.28±10.44)IU/L,(4.12±1.03)mmol/L,(30.47±11.29)μmol/L and(89.24±17.67)μmol/L after the treatment,significantly lower than(58.13±13.24)IU/L,(63.22±13.47)IU/L,(7.13±2.37)mmol/L,(47.82±13.43)μmol/L and(125.08±27.69)μmol/L of the control group(P<0.05).There was no significant difference in the curative effect classification data between the two groups,however,the total effective rate of treatment of the study group was 94.74%(72/76),significantly higher than 76.32%(58/76)of the control group(χ2=10.417,P<0.001).CONCLUSIONThe ascites concentration combined with antibiotics can effectively reduce the levels of laboratory indexes of the liver cirrhosis patients complicated with ascites infection and achieve remarkable curative effect,and it is worthy to be promoted in the hospital.
OBJECTIVE To observe the effect of ascites concentration combined with antibiotics on laboratory indexes and curative effects of the liver cirrhosis patients complicated with ascites infection.METHODS A total of 152 liver cirrhosis patients complicated with ascites infection who were treated in the hospital from May 2015 to Jun2017 were recruited as the study objects and randomly divided into the control group and the study group.The control group was treated with antibiotics,while the study group was given the ascites concentration therapy on basis of the treatment of the control group.The blood specimens were collected to detect the laboratory indexes,including alanine aminotransferase(ALT),aspartate aminotransferase(AST),blood urea nitrogen(BUN),total bilirubin(TBIL)and serum creatinine(Scr).The curative effects of the patients were evaluated on the basis of Traditional Chinese Medicine combined with western medicine evaluation scale for liver cirrhosis-induced ascites.RESULTS The levels of ALT,AST,BUN,TBIL and Scr of the study group were respectively(41.07±12.11)IU/L,(34.28±10.44)IU/L,(4.12±1.03)mmol/L,(30.47±11.29)μmol/L and(89.24±17.67)μmol/L after the treatment,significantly lower than(58.13±13.24)IU/L,(63.22±13.47)IU/L,(7.13±2.37)mmol/L,(47.82±13.43)μmol/L and(125.08±27.69)μmol/L of the control group(P<0.05).There was no significant difference in the curative effect classification data between the two groups,however,the total effective rate of treatment of the study group was 94.74%(72/76),significantly higher than 76.32%(58/76)of the control group(χ2=10.417,P<0.001).CONCLUSIONThe ascites concentration combined with antibiotics can effectively reduce the levels of laboratory indexes of the liver cirrhosis patients complicated with ascites infection and achieve remarkable curative effect,and it is worthy to be promoted in the hospital.
引文
[1]钟华平,周智,廖桂兰,等.肝硬化腹水并发结核性腹膜炎的预警指标分析[J].临床肝胆病杂志,2014,29(4):357-359.
[2]王虹,刘慧,邵明鑫,等.重症肝病患者腹水感染的调查与危险因素分析[J].中华医院感染学杂志,2017,27(2):333-336.
[3]李进,胡振斌,李月翠,等.肝硬化患者自发性细菌性腹膜炎腹水感染的相关因素分析[J].中华医院感染学杂志,2014,24(21):5347-5349.
[4]马玉秀,于国英,辛晓恩,等.肝硬化患者自发性腹膜炎腹水感染的病原菌分析[J].中华医院感染学杂志,2014,24(16):3915-3917.
[5] Togami S,Hori S,Kamio M,et al.Clinical usefulness of concentrated ascites reinfusion therapy(CART)for gynecological cancer patients with refractory massive ascites due to cancerous peritonitis[J].Eur J Gynaecol Oncol,2014,35(3):301-303.
[6] Fang N,Zhang HQ,He B,et al.Clinicopathological characteristics and prognosis of gastric cancer with malignant ascites[J].Tumour Biol,2014,35(4):3261-3268.
[7] Elliott JA,McCormack O,Tchrakian N,et al.Eosinophilic ascites with marked peripheral eosinophilia:a diagnostic challenge[J].Eur J Gastroenterol Hepatol,2014,26(4):478-484.
[8]朱龙川,朱萱.血降钙素原和C-反应蛋白对肝硬化腹水非多形核细胞性自发性细菌性腹膜炎的诊断意义[J].中华消化杂志,2016,36(3):161-166.
[9] Pan MS,Wu RH,Sun DP,et al.Renal vein stenosis with transudative ascites from graft after renal transplantation with good response after percutaneous stent placement[J].Transplant Proc,2014,46(2):598-601.
[10] Szeto O,Finkelstein A,Wei XJ,et al.Leishmania amastigotes in the ascites of a HIV-positive patient[J].Diagn Cytopathol,2014,42(5):428-430.
[11] Alhmoud T,Arif H,Auyang E,et al.Chronic abdominal pain,ascites,and diarrhea:seeing red[J].Dig Dis Sci,2014,59(4):740-743.
[12] Lohani K,Shetty S,Sharma P,et al.Pseudomyxoma peritonei:inflammatory responses in the peritoneal microenvironment[J].Ann Surg Oncol,2014,21(5):1441-1447.
[13] Russo TA,Olson R,Macdonald U,et al.Aerobactin mediates virulence and accounts for increased siderophore production under iron-limiting conditions by hypervirulent(hypermucoviscous)Klebsiella pneumoniae[J].Infect Immun,2014,82(6):2356-2367.
[14]陈洁,张欣欣.乙型肝炎病毒特征与肝硬化及原发性肝细胞癌关系的研究进展[J].中华肝脏病杂志,2014,22(2):153-155.
[15] Bottari NB,Tonin AA,Fighera R,et al.Neospora caninum and Toxoplasma gondii:relationship between hepatic lesions,cytological and biochemical analysis of the cavitary liquid during the acute phase of the diseases in experimental models[J].Exp Parasitol,2014,136:68-73.
[16] Mahdi H,Gojayev A,Buechel M,et al.Surgical site infection in women undergoing surgery for gynecologic cancer[J].Int J Gynecol Cancer,2014,24(4):779-786.
[2]王虹,刘慧,邵明鑫,等.重症肝病患者腹水感染的调查与危险因素分析[J].中华医院感染学杂志,2017,27(2):333-336.
[3]李进,胡振斌,李月翠,等.肝硬化患者自发性细菌性腹膜炎腹水感染的相关因素分析[J].中华医院感染学杂志,2014,24(21):5347-5349.
[4]马玉秀,于国英,辛晓恩,等.肝硬化患者自发性腹膜炎腹水感染的病原菌分析[J].中华医院感染学杂志,2014,24(16):3915-3917.
[5] Togami S,Hori S,Kamio M,et al.Clinical usefulness of concentrated ascites reinfusion therapy(CART)for gynecological cancer patients with refractory massive ascites due to cancerous peritonitis[J].Eur J Gynaecol Oncol,2014,35(3):301-303.
[6] Fang N,Zhang HQ,He B,et al.Clinicopathological characteristics and prognosis of gastric cancer with malignant ascites[J].Tumour Biol,2014,35(4):3261-3268.
[7] Elliott JA,McCormack O,Tchrakian N,et al.Eosinophilic ascites with marked peripheral eosinophilia:a diagnostic challenge[J].Eur J Gastroenterol Hepatol,2014,26(4):478-484.
[8]朱龙川,朱萱.血降钙素原和C-反应蛋白对肝硬化腹水非多形核细胞性自发性细菌性腹膜炎的诊断意义[J].中华消化杂志,2016,36(3):161-166.
[9] Pan MS,Wu RH,Sun DP,et al.Renal vein stenosis with transudative ascites from graft after renal transplantation with good response after percutaneous stent placement[J].Transplant Proc,2014,46(2):598-601.
[10] Szeto O,Finkelstein A,Wei XJ,et al.Leishmania amastigotes in the ascites of a HIV-positive patient[J].Diagn Cytopathol,2014,42(5):428-430.
[11] Alhmoud T,Arif H,Auyang E,et al.Chronic abdominal pain,ascites,and diarrhea:seeing red[J].Dig Dis Sci,2014,59(4):740-743.
[12] Lohani K,Shetty S,Sharma P,et al.Pseudomyxoma peritonei:inflammatory responses in the peritoneal microenvironment[J].Ann Surg Oncol,2014,21(5):1441-1447.
[13] Russo TA,Olson R,Macdonald U,et al.Aerobactin mediates virulence and accounts for increased siderophore production under iron-limiting conditions by hypervirulent(hypermucoviscous)Klebsiella pneumoniae[J].Infect Immun,2014,82(6):2356-2367.
[14]陈洁,张欣欣.乙型肝炎病毒特征与肝硬化及原发性肝细胞癌关系的研究进展[J].中华肝脏病杂志,2014,22(2):153-155.
[15] Bottari NB,Tonin AA,Fighera R,et al.Neospora caninum and Toxoplasma gondii:relationship between hepatic lesions,cytological and biochemical analysis of the cavitary liquid during the acute phase of the diseases in experimental models[J].Exp Parasitol,2014,136:68-73.
[16] Mahdi H,Gojayev A,Buechel M,et al.Surgical site infection in women undergoing surgery for gynecologic cancer[J].Int J Gynecol Cancer,2014,24(4):779-786.