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- Spontaneous Bacterial Peritonitis in Adult Patients with Primary Nephrotic Syndrome
- 成年肝硬化病患之腹水控制原則
- 肝硬化病人發燒原因之探討
- 肝硬化患者的自發性細菌性腹膜炎
- 自發性細菌性腹膜炎
- Risk Factors for Spontaneous Bacterial Empyema in Cirrhotic Patients with Hydrothorax
- Serum and Ascitic Concentration of C3, C4 and Protein in Cirrhotic Patients with Spontaneous Bacterial Peritonitis
- Spontaneous Bacterial Peritonitis--With Emphasis on Predisposing and Prognostic Factors
- 自發性細菌性腹膜炎近貌
- 自發性細菌性腹膜炎之早期診斷
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題 名 | Spontaneous Bacterial Peritonitis in Adult Patients with Primary Nephrotic Syndrome=原發性腎病症候群成年患者之自發性細菌性腹膜炎 |
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作 者 | 陳妙禎; 林景坤; 許國泰; | 書刊名 | 長庚醫學 |
卷 期 | 22:2 1999.06[民88.06] |
頁 次 | 頁227-233 |
分類號 | 415.74 |
關鍵詞 | 自發性細菌性腹膜炎; 成人原發性腎病症候群; Spontaneous bacterial peritonitis; Primary nephrotic syndrome; |
語 文 | 英文(English) |
中文摘要 | 背景:細菌感染在腎病症候群的病人是很常見的併發症,在小孩腎病症候群的病 人常會有自發性細菌性腹膜炎的發生,但在成人則極為罕見。因此本研究針對成人腎病症候 群併自發性細菌性腹膜炎的患者,分析其臨床變化、致病菌及預後。方法:本文採回溯性分 析高雄長庚紀念醫院 12 年來 10 例原發性成人腎病症候群罹患自發性細菌性腹膜炎的病人 。結果:病人平均年齡為 30.5 歲,男性 9 人、女性 1 人。所有的病人全身都嚴重浮腫合 併有腹水,病人的臨床表現以廣泛性腹痛、肋膜積水、發燒、畏寒、白血球過高為主,其餘 的症狀如反彈性壓痛、腹瀉、嘔吐則較少見。 病人血漿白蛋白中間值為 1.4 g/dL,白血球 中間值為 12,400/mm �纂C腹水外觀皆呈混濁狀。 細菌培養結果:革蘭氏陰性桿菌佔 60 % (n=6),其中 1 位為革蘭氏陰性厭氧菌感染;革蘭氏陽性菌佔 30 % (n=3);1 位腹水及血 液培養結果皆為陰性。7 位病人經抗生素治療後痊癒,3 位病人雖接受治療但仍不治死亡。 結論:自發性細菌性腹膜炎在原發性成人腎病症候群的病人雖然罕見,但如延誤診斷常會導 致死亡。因此在原發性腎病症候群合併有腹水的病人,若出現腹痛的症狀,皆需懷疑自發性 細菌性腹膜炎的可能性。綜合臨床症狀、腹水檢查及血液培養能幫助正確診斷,唯有早期診 斷及適當的抗生素治療才能改善病人的預後。 |
英文摘要 | Background:Susceptibility to bacterial infection is a common problem in nephrotic patients. Spontaneous bacterial peritonitis, although characteristic of nephrotic children, is extremely rare in adults. Methods:A retrospective review was performed on all adult patients with the discharge diagnoses of primary nephrotic syndrome and spontaneous bacterial peritonitis treated between 1986 and 1998 at Chang Gung Memorial Hospital in Kaohsiung, Taiwan. Ten patients were included in this study, 9 of them men and one woman. The average age was 30.5 years. Results:All the patients had signs of active nephrosis and presented with diffuse abdominal pain, ascites, fever and/or chills. Thirty percent (3/10) of the causative pathogens were gram-positive bacteria and 60% (6/10) were gram-negative bacteria. One patient had sterile cultures. Seven patients recovered after antibiotic treatment for 1 to 2 weeks. Three patients died of septic shock. Conclusion:Therefore, to improve patient outcome, it is essential to establish a diagnosis early and to initiate broad-spectrum antimicrobial therapy even before culture results are available. |
本系統中英文摘要資訊取自各篇刊載內容。