복수를 동반한 간경변증 환자에서 원발성 세균성 복막염과 배양음성 중성세포성 복수의 비교

Abstract

Definition of spontaneous bacterial peritonitis is the inflammation of the peritoneum in which no primary focus of infection is evident. Spontaneous bacterial peritonitis is a serious and sometimes fatal complication in cirrhotic patients. therefore earlier detection and appropriate treatment are important for good outcome. But clinical significance and prognosis of Culture Negative Neutrocytic Ascites in cirrhotic patients is controversial. In our study, clinical and bacteriological features and prognosis were analyzed in both 20 cirrhotic patients with culture positive bacterial peritonitis and 57 cirrhotic patients with ascitic fluid polymorphonuclear count greater than 250cells/㎣, negative Ascites fluid culture and negative symptom. On admission there were no significant difference between two groups related to age, sex, symptom, transaminase level, serum bilirubin, serum creatinine and polymorphonuclear leukocytes count, glucose, protein in ascitic fluid except serum albumin. There was also no difference in in-hospital mortality. But, in comparision of survival group and non-survival group, high score of Child's classification and more complication was noted in non-survival group. In conclusion, the spontaneous bacterial peritonitis and culture negative neutrocytic ascites were variants of th same disease and prognosis of spontaneous bacterial peritonitis dose not depend on either positive result or negative result of the culture but depends on the severity of cirrhosis itself in spontaneous bacterial peritonitis patients.