这位患者是否患有细菌性腹膜炎或门门高血压? 我如何进行体检查并分析结果?
Camilla L Wong1, Jayna Holroyd-Leduc, Kevin E Thorpe
1Division of Geriatric Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
JAMA
|March 13, 2008
概括
在血液培养瓶中注射血液,提高了诊断产量. 特定的性流体参数可以帮助诊断自发细菌性腹膜炎和门性高血压.
科学领域:
- 胃肠病学 胃肠病学
- 肝病学 肝病学是一种肝病学.
- 内部医学 内部医学
背景情况:
- 腹腔是治疗炎的一种常见程序.
- 指示包括感染评估,门高血压评估和耐火性炎治疗.
研究的目的:
- 系统地审查对降技术的证据,以减少不良事件.
- 评估改善诊断产量的方法.
- 确定性流体分析的准确性,以诊断自发细菌性腹膜炎和门腔高血压.
主要方法:
- 来自Medline和EMBASE (1966-2007) 的英语语言研究的系统审查.
- 包括对体干预的研究 (凝血,针类型,超声波,床边注射,血扩展器).
- 包括对性液体生物化学分析的研究,用于诊断自发细菌性腹膜炎和门性高血压.
主要成果:
- 程序前的凝血试验可能不需要.
- 与14度针相比,15度针可以减少并发症.
- 培养瓶的立即床边注射显著改善了诊断产量.
- 酸性流体多态核白细胞 (PMN) 数量>250细胞/μL,白细胞数量>1000细胞/μL,pH<7.35,或血酸性流体pH梯度≥0.10增加自发细菌周周炎的可能性.
- 血清酸白蛋白梯度<1.1 g/dL降低了门性高血压的可能性.
结论:
- 建议在床边用血培养瓶中注射性液.
- 特定的液参数有助于诊断自发细菌性腹膜炎.
- 血清酸蛋白梯度对于评估门门高血压有价值.
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