Luận án có ý nghĩa khoa học và thực tiễn, là đề tài liên quan đến nhiều chuyên ngành như: Nội tiêu hóa, truyền nhiễm và vi sinh. Đề tài có tính thực tiễn đóng góp nằm trong thực hành lâm sàng: Mô tả đặc điểm lâm sàng chính của bệnh viêm màng bụng nhiễm khuẩn tự phát ở bệnh nhân xơ gan cổ trướng. Cơ cấu chủng vi khuẩn, đánh giá mức độ nhạy cảm với kháng sinh của các chủng vi khuẩn phân lập được. Đánh giá hiệu quả điều trị của phác đồ khởi đầu với 2 kháng sinh: Cefotaxim 4g trên ngày + Ciprofloxacin 1gngày và kết quả điều trị theo kháng sinh đồ và theo kinh nghiệm.
B GIÁO D C VA ÀO T O VI N NGHIÊN C U KHOA H C Y D B QU C PHÒNG C LÂM SÀNG 108 V THÀNH TRUNG M TS C I M LÂM SÀNG, C N LÂM SÀNG VÀ K T QU I U TR VIÊM MÀNG B NG NHI M KHU N T B NH NHÂN X GAN LU N ÁN TI N S Y H C Hà Nôi - 2019 PHÁT B GIÁO D C VA ÀO T O VI N NGHIÊN C U KHOA H C Y D B QU C PHÒNG C LÂM SÀNG 108 V THÀNH TRUNG M TS C I M LÂM SÀNG, C N LÂM SÀNG VÀ K T QU I U TR VIÊM MÀNG B NG NHI M KHU N T B NH NHÂN X GAN Chuyên ngành: N i Tiêu hoá Mã s : 62.72.01.43 LU N ÁN TI N S Y H C Ng ih ng d n khoa h c: GS.TS MAI H NG BÀNG PGS.TS PHAN QU C HỒN Hà Nơi - 2019 PHÁT L I CAM OAN Tôi xin cam oan s li u k t qu nghiên c u lu n án trung th c ch a h c s d ng b o v m t h c v M i s giúp cho vi c th c hi n lu n án ã lu n v n ã c c m n thơng tin trích d n c ch rõ ngu n g c rõ ràng c phép công b Tác gi lu n án V THÀNH TRUNG L IC M N Trong su t trình h c t p nghiên c u, ã nh n s giúp c r t nhi u c a cá nhân t p th V i lòng bi t n sâu s c, xin g i l i c m n chân thành t i GS.TS Mai H ng Bàng, PGS.TS Phan Qu c Hồn, nh ng ng tình h i th y ã t n ng d n Tôi xin chân thành c m n Khoa Tiêu hóa, Ph òng L u tr h s , Phòng K ho ch t ng h p thu c B nh vi n B ch Mai,B mơn khoa N i tiêu hóa, Phòng sau i h c thu c B nh vi n TWQ tr c ti p tham gia gi ng d y giúp 108, quý Th y, Cô giáo ã tơi q trình h c t p th c hi n lu n án Tôi xin chân thành c m n lãnh tơi có c h i h c t p nâng cao trình o c quan c p ã t o i u ki n cho Cu i cùng, xin g i l i tri ân sâu s c bè ã ln n gia ình, ng i thân b n ng viên, h tr t o i u ki n t t nh t cho su t trình h c t p, làm vi c hoàn thành lu n án Hà N i, ngày 10 tháng 03 n m 2019 Tác gi Lu n án V Thành Trung DANH M C VI T T T Ti ng Vi t: BANC : B nh án nghiên c u BC NTT : B ch c u a nhân trung tính BN : B nh nhân CMTH : Ch y máu tiêu hóa CS : C ng s DCT : D ch c tr ng TKS : i u tr kháng sinh TTKN : i u tr theo kinh nghi m HCGT : H i ch ng Gan Th n HCNG : H i ch ng não gan NKH : Nhi m khu n huy t TANTMC : T ng áp l c t nh m ch c a THBH : Tu n hoàn bàng h TMDD : T nh m ch d dày TMTQ : T nh m ch th c qu n VMBNKTP : Viêm màng b ng nhi m khu n t phát XHTH : Xu t huy t tiêu hóa Ti ng Anh BT : S di chuy n c a vi khu n (Bacterial translocation) CAIDS : H i ch ng r i lo n mi n d ch liên quan n x gan (Cirrhosis- associated immune dysfunction syndrome) GALT : Mô b ch huy t liên quan Tissue) n ru t (Gut Associated Lymphoid GOV : Giãn t nh m ch th c qu n d dày (Gastroesophaeal varices) HE : B nh não gan (Hepatic encephalopathy) HRS : H i ch ng gan th n (Hepatorenal Syndrome) IGV : Giãn t nh m ch t i d dày không liên t c v i th c qu n (Isolated gastricvarices) MIC :N ng c ch t i thi u (Minimal Inhibitory Concentration) NAFLD : B nh gan nhi m m không r u (nonalcoholic fatty liver disease) NSAIDs : Các thu c kháng viêm không steroid (Nonsteroidal antiinflammatory drugs) P.H : T ng áp l c t nh m ch c a (Portal hypertension) PMNL : B ch c u a nhân (Polymorphonuclear Leukocytes) PSS : Các nhánh bàng h c a-ch (porto-systemic shunts) RES : H th ng l SBP : Viêm màng b ng nhi m khu n t phát (spontaneous bacterial i n i mô (Reticulo Endothelial System) peritonitis) SIBO : Tình tr ng phát tri n m c c a vi khu n ru t non (Small IntestinalBacterial Overgrowth) SeBP : Viêm phúc m c nhi m khu n th phát (Secondary bacterial peritonitis) SIRS : H i ch ng viêm h th ng (systemic inflammatory response syndrome) SFP : Viêm phúc m c t phát n m (Spontaneous fungal peritonitis) TIPS : K thu t t o shunt c a ch gan (transjugular intrahepatic portosystemic shunt) M CL C DANH M C B NG DANH M C BI U DANH M C HÌNH DANH M C S TV N Ch ng 1: T NG QUAN TÀI LI U X GAN: NGUYÊN NHÂN, NH NG BI N I H TH NG,LÂM SÀNG VÀ BI N CH NG 1.1 Khái quát v x gan 1.2 Nh ng nguyên nhân gây x gan 1.3 Các bi n c tr i v gi i ph u, mi n d ch, vi sinh h c s hình thành d ch ng x gan 1.3.1 Các bi n i v gi i ph u x gan 1.3.2 Các r i lo n mi n d ch liên quan 1.3.3 Các bi n n x gan i v vi sinh h c liên quan 1.3.4 S hình thành d ch c tr n x gan 10 ng x gan 12 1.4 Tri u ch ng lâm sàng, c n lâm sàng b nh nhân x gan 13 1.4.1 Tri u ch ng lâm sàng 13 1.4.2 Tri u ch ng c n lâm sàng 14 1.5 Các bi n ch ng c a x gan 15 1.5.1 Xu t huy t tiêu hóa t ng áp l c t nh m ch c a 15 1.5.2 H i ch ng gan th n 16 1.5.3 B nh não gan 17 1.5.4 Nhi m trùng b nh nhân x gan 18 VIÊM MÀNG B NG NHI M KHU N T PHÁT B NH NHÂN X GAN 19 2.1 Khái quát v VMBNKTP 19 2.2 T n su t phân b 20 2.3 C ch b nh sinh gây VMBNKTP 22 2.3.1 Thuy t Bacterial translocation –BT c i n: 22 2.3.2 C ch sinh b nh h c VMBNKTP c a Such.J Bruce A.Runyon (1998) : 23 2.3.3 C ch sinh b nh h c VMBNKTP c a Wiest R, Garcia-Tsao G (2005) 24 2.3.4 C ch sinh b nh h c VMBNKTP c a Anadon MN Arroyo V (2007); Runyon B.A (2010): 25 2.3.5 C ch sinh b nh h c VMBNKTP c a Such J (2013) 25 2.3.6 C ch sinh b nh h c VMBNKTP c a Reiner Weist c ng s (2014): 26 2.3.7.T ng h p v c ch b nh sinh VMBNKTP 27 2.4 Lâm sàng ch n oánVMBNKTP 27 2.5 Các xét nghi m ch n oán VMBNKTP 28 2.5.1 Các ph ng pháp c y d ch c tr ng 28 2.5.2 Ch n oán VMBNKTP d a ch s B ch c u a nhân d ch c tr ng 29 2.5.3 Ch n oán VMBNKTP d a vào DNA vi khu n có d ch c tr ng 30 2.6 Ch n oán phân bi t 31 2.6.1 Viêm phúc m c nhi m khu n th phát 31 2.6.2 Nhi m khu n huy t 32 2.6.3 Viêm phúc m c t phát n m 33 I U TR VIÊM MÀNG B NG NHI M KHU N T PHÁT 33 3.1 Nguyên t c i u tr 33 3.2 i u tr VMBNKTP 34 3.2.1 S d ng kháng sinh theo kháng sinh 34 3.2.2 S d ng kháng sinh theo kinh nghi m 34 3.2.3 S d ng kháng sinh k t h p li u pháp bù Albumin 36 3.2.4 ánh giá hi u qu i u tr kháng sinh 36 3.3 i u tr d phòng VMBNKTP 37 3.4 Tình hình kháng kháng sinh 37 ngồi n Tình hình nghiên c u VMBNKTP Ch ng 2: 2.1 IT it NG VÀ PH c 38 NG PHÁP 40 ng nghiên c u 40 2.1.1 Tiêu chu n ch n b nh nhân 40 2.1.2 Tiêu chu n lo i tr b nh nhân 40 2.2 Ph ng pháp nghiên c u 41 2.2.1 Thi t k nghiên c u 41 2.2.2 C m u nghiên c u 41 2.3 Ph ng ti n nghiên c u 41 2.4 Các b c ti n hành nghiên c u 44 2.4.1 M u b nh án nghiên c u 44 2.4.2 Th m khám lâm sàng c n lâm sàng 44 2.4.3 Các thang i m ánh giá m c 2.4.4 Tri u ch ng c n ng, th c th 2.4.5 Xét nghi m d ch c tr 2.4.6 ng x gan bi n ch ng khác 45 b nh nhân x gan có VMBNKTP 49 b nh nhân x gan có VMBNKTP 50 nh danh vi khu n kháng sinh 53 2.4.7 Th c hi n trình i u tr 56 2.4.8 i u tr x gan có bi n ch ng VMBNKTP 59 2.5 Phân tích x lý s li u 63 2.6 Sai s kh c ph c 63 2.7 H n ch c a 2.8 o tài: 63 c nghiên c u 64 Ch ng 3:K T QU NGHIÊN C U 65 3.1 3.1.1 C I M LÂM SÀNG VÀ C N LÂM SÀNG X GAN 65 c i m tu i gi i nhóm nghiên c u 65 3.1.2 T l m c b nh theo nhóm tu i 3.1.3 c i m y u t ti n s 3.1.4 c i m lâm sàng b nh nhân x gan 65 nhóm BN x gan có VPMNKTP 66 b nh nhân x gan có bi n ch ng VMBNKTP 66 3.1.5 Phân lo i m c x gan theo Child-Pugh 67 3.1.6 K t qu huy t h c sinh hóa 3.1.7 M c giãn TMTQ 3.2 Xét nghi m d ch c tr BN x gan có VMBNKTP 68 b nh nhân VMBNKTP 70 ng b nh nhân VMBNKTP 71 b ng b nh nhân x gan có VMBNKTP 71 3.2.1 c i m d ch 3.2.2 c i m d ch c tr 3.2.3 c i m v sinh hóa-hóa nghi m d ch c tr 3.2.5 S l ng k t qu xét nghi m Rivalta 71 ng BC NTT d ch c tr 3.2.6 K t qu c y khu n d ch c tr 3.2.7 K t qu ng 71 ng 72 ng BN x gan có VMBNKTP 72 nh danh vi khu n BN x gan có VMBNKTP 73 3.2.8 VPMNKTP lo i vi khu n khác 74 3.3 VMBNKTP VÀ CÁC BI N CH NG KÈM THEO 74 3.3.1 Các bi n ch ng b nh nhân x gan có VMBNKTP 74 3.3.2 Các lo i vi khu n gây nhi m khu n huy t 75 3.4 KHÁNG SINH VÀ TÌNH TR NG KHÁNG KHÁNG SINH, A KHÁNG 75 3.4.1 K t qu kháng sinh 76 3.4.2 Tình tr ng kháng kháng sinh nhóm Cephalosporine TH3,nhóm Fluoro quinolone tìnhtr ng a kháng 83 3.5 K T QU 3.5.1 K t qu I U TR VMBNKTP 85 i u tr chung b nh nhân x gan có VMBNKTP 85 variceal hemorrhage: a meta-analysis World J Gastroenterol, 21(8), pp 2534-41 54 Parvinian, A and R.C Gaba,(2014) Outcomes of TIPS for Treatment of Gastroesophageal Variceal Hemorrhage Seminars in Interventional Radiology, 31(3), pp 252-257 55 Garcia-Pagan, J.C., et al (2013) Use of early-TIPS for high-risk variceal bleeding: results of a post-RCT surveillance study J Hepatol 58(1), pp 45-50 56 Kiser TH, M.R., Fish DN (2009).Treatment of hepatorenal syndrome Pharmacotherapy., 29(10), pp 1196-1211 57 Salerno, F., et al (2008) Diagnosis, prevention and treatment of hepatorenal syndrome in cirrhosis Postgrad Med J, 84(998), pp 662-70 58 Ginès, PP.a.S., R.W (2009) Renal failure in cirrhosis N Engl J Med 361: pp 1279- 1290 59 Sanyal AJ, B.T Garcia-Tsao G, (2008).Terlipressin Study Groupp A randomized, prospective, double-blind, placebo-controlled trial of terlipressin for type hepatorenal syndrome Gastroenterology., 134(5), pp 1360-1368 60 Nazar, A., et al (2010) Predictors of Response to Therapy with Terlipressin and Albumin in Patients with Cirrhosis and Type Hepatorenal Syndrome Vol 51 219-26 61 EzequielRodríguez, C., ElsaSolà, RogelioBarreto, et all (2014) Terlipressin and albumin for type-1 hepatorenal syndrome associated with sepsis Journal of Hepatology, 60(5), pp 955-961 62 Bruce A Runyon, M Uptodate.com, (2017) Hepatorenal syndrome 63 Andrew PP Keaveny, A.C., (2015).Complications of Cirrhosis: Evaluation and Management books.com.vn, 64 Dundar, H.Z and T Yılmazlar,(2015).Management of hepatorenal syndrome World Journal of Nephrology, 4(2), pp 277-286 65 Vilstrup H., A.PP., Bajaj J (2014), Hepatic encephalopathy in chronic liver disease: 2014 Practice Guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver Hepatology., 60: pp 715-735 66 Patidar, K.R and J.S Bajaj, (2015) Covert and Overt Hepatic Encephalopathy: Diagnosis and Management Clin Gastroenterol Hepatol, 13(12), pp 2048-61 67 R.F., B (2002) Pathophysiology of hepatic encephalopathy: a new look at ammonia Metab Brain Dis., 17: pp 221-227 68 Aldridgea D.R., Shawcross D.L (2015) Pathogenesis of hepatic encephalopathy: role of ammonia and systemic inflammation J Clin Exp Hepatol 5: pp 7-20 69 R.K., D (2012) Gut microbiota, inflammation and hepatic encephalopathy: a puzzle with a solution in sight J Clin Exp Hepatol 2: pp 207-210 70 Rai R, S.V., Dhiman RK (2015) Gut microbiota: its role in hepatic encephalopathy J Clin Exp Hepatol 5(1), pp 29-36 71 Lunia M.K., S.B.C., Sachdeva S (2013) Small intestinal bacterial overgrowth and delayed orocecal transit time in patients with cirrhosis and low-grade hepatic encephalopathy Hepatol Int 7: pp 268-273 72 Dam, G., et al (2016) Proton pump inhibitors as a risk factor for hepatic encephalopathy and spontaneous bacterial peritonitis in patients with cirrhosis with ascites Hepatology, 64(4), pp 1265-72 73 Tsai, C.F., et al (2017) Proton Pump Inhibitors Increase Risk for Hepatic Encephalopathy in Patients With Cirrhosis in A Population Study Gastroenterology, 152(1), pp 134-141 74 Elwir, S and R.S (2017) Hepatic Encephalopathy: An Update on the Pathophysiology and Therapeutic Options J Clin Transl Hepatol, 5(2), pp 142-151 75 Jalan, R., et al (2014) Bacterial infections in cirrhosis: a position statement based on the EASL Special Conference 2013 J Hepatol, 60(6), pp 1310-24 76 Tandon, PP and G Garcia-Tsao,(2008) Bacterial infections, sepsis, and multiorgan failure in cirrhosis Semin Liver Dis, 28(1), pp 26-42 77 Borzio, M., et al (2001) Bacterial infection in patients with advanced cirrhosis: a multicentre prospective study Dig Liver Dis, 33(1), pp 41-8 78 Fernandez, J., et al (2002) Bacterial infections in cirrhosis: epidemiological changes with invasive procedures and norfloxacin prophylaxis Hepatology, 35(1), pp 140-8 79 Bernard, B., et al (1999), Antibiotic prophylaxis for the prevention of bacterial infections in cirrhotic patients with gastrointestinal bleeding: a meta-analysis Hepatology, 29(6), pp 1655-61 80 Brann, O.S (2001) Infectious complications of cirrhosis Curr Gastroenterol Rep, 3(4), pp 285-92 81 Fiore, M., L Andreana, and S (2016).Treatment of spontaneous bacterial peritonitis: beyond the current international guidelines Liver Int, 36(6), pp 918 82 Fiore, M., et al (2017) Current concepts and future strategies in the antimicrobial therapy of emerging Gram-positive spontaneous bacterial peritonitis World J Hepatol, 9(30), pp 1166-1175 83 HO., C (1964) Spontaneous peritonitis and bacteremia in Laennec's cirrhosis caused by enteric organisms A relatively common but rarely recognized syndrome Ann Intern Med 1964 April; 60(4), pp 568580 84 Angeloni S, L.C Parente A, Venditti M, Giordano A, Merli M, Riggio O.(2008).Efficacy of current guidelines for the treatment of spontaneous bacterial peritonitis in the clinical practice World J Gastroenterol 14(17), pp 2757-2762 85 Singal, A.K H Salameh, and PP.S Kamath, (2014) Prevalence and in-hospital mortality trends of infections among patients with cirrhosis: a nationwide study of hospitalised patients in the United States Aliment Pharmacol Ther, 40(1), pp 105-12 86 Oladimeji, A.A., et al (2013), Prevalence of spontaneous bacterial peritonitis in liver cirrhosis with ascites Pan Afr Med J, 15: pp 128 87 Teltschik, Z., Wiest, R., Beisner, J., Nuding, S., Hofmann, C., Schoelmerich, J et al (2012) Intestinal bacterial translocation in rats with cirrhosis is related to compromised Paneth cell antimicrobial host defense Hepatology 55, pp 1154- 1163 88 Such J, R.B (1998), Spontaneous bacterial peritonitis Clin Infect Dis 27(4), pp 669-674 89 Bellot P, F.R., Such J (2013) Pathological bacterial translocation in cirrhosis: pathophysiology, diagnosis and clinical implications Liver Int 33(1), pp 31-39 90 Lippi, G., et al (2014) Laboratory diagnostics of spontaneous bacterial peritonitis Clin Chim Acta, 43, pp 164-70 91 Friedrich, K., et al (2016) Microbiology and resistance in first episodes of spontaneous bacterial peritonitis: implications for management and prognosis J Gastroenterol Hepatol, 31(6), pp 1191-5 92 Angeli, K (2010) EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis.Journal of Hepatology; May, 53(3), pp 397-417 93 Angeloni, S., Nicolini, G., Merli, M., Nicolao, F., Pinto, G., Aronne, T et al (2003) Validation of automated blood cell counter for the determination of polymorphonuclear cell count in the ascitic fluid of cirrhotic patients with or without spontaneous bacterial peritonitis Am J Gastroenterol 98: pp 1844-1848 94 Oliviero Riggio, S.A (2008) Accuracy of the automated cell counters for management of spontaneous bacterial peritonitis World J Gastroenterol 14(37), pp 5689 - 5694 95 Nguyen Khac, E and Nousbaum, J.B (2008).Review article: utility of reagent strips in diagnosis of infected ascites in cirrhotic patients Aliment Pharmacol Ther 28: pp 282-288 96 Chugh, K., et al (2015) Diagnosing bacterial peritonitis made easy by use of leukocyte esterase dipsticks International Journal of Critical Illness and Injury Science, 5(1), pp 32-37 97 Burri, E., et al (2013) Measurement of calprotectin in ascitic fluid to identify elevated polymorphonuclear cell count World Journal of Gastroenterology : WJG, 19(13), pp 2028-2036 98 Abdel-Razik, A., et al (2016) Ascitic Fluid Calprotectin and Serum Procalcitonin as Accurate Diagnostic Markers for Spontaneous Bacterial Peritonitis Gut Liver, 10(4), pp 624-31 99 G Soriano, Ó.E M Montemayor, (2011).Bacterial DNA in the diagnosis of spontaneous bacterial peritonitis Alimentary Pharmacology & Therapeutics 133(2), pp 275-284 100 Francés R, Z.PP., González-Navajas JM, et al (2008) Bacterial DNA in patients with cirrhosis and noninfected ascites mimics the soluble immune response established in patients with spontaneous bacterial peritonitis Hepatology 47: pp 978-985 101 Sugihara T, K.M., Maeda Y, et al (2009) Rapid identification of bacterial species with bacterial DNA microarray in cirrhotic patients with spontaneous bacterial peritonitis Inter Med 48: pp 3-10 102 Bruns T, S.S., Straube E, et al (2009) Identification of bacterial DNA in neutrocytic and non-neutrocytic cirrhotic ascites by means of a multiplex polymerase chain reaction Liver Int 29: pp 1206-1214 103 Bruns, T and A Stallmach, (2014) Spontaneous and secondary bacterial peritonitis in cirrhotic patients with ascites Zentralbl Chir, 139(2), pp 160-7 104 Krastev, N., et al (2013) Diagnosis of spontaneous and secondary bacterial peritonitis in patients with hepatic cirrhosis and ascites Khirurgiia (Sofiia), (3), pp 20-5 105 Farkas, J (2014) Secondary Bacterial Peritonitis https://emcrit.org › pulmcrit 106 Soriano G., C.J., Alvarez C., Girbau A., (2010) Secondary bacterial peritonitis in cirrhosis: a retrospective study of clinical and analytical characteristics, diagnosis and management J Hepatol 52(1), pp 39-44 107 Akriviadis E.A., R.B.A (1990) Utility of an algorithm in differentiating spontaneous from secondary bacterial peritonitis Gastroenterology.98:127 98(1), pp 127-133 108 Navasa, M., J Fernandez, and J Rodes, (1999) Bacterial infections in liver cirrhosis Ital J Gastroenterol Hepatol, 31(7), pp 616-25 109 Wong, F., et al (2005), Sepsis in cirrhosis: report on the 7th meeting of the International Ascites Club Gut, 54(5), pp 718-25 110 Choi, S.H., et al (2004) Clinical significance of untreated Candida species isolated from ascites in cirrhotic patients Scand J Infect Dis, 36(9), pp 649-55 111 Hwang, S.Y., et al (2014) Spontaneous fungal peritonitis: a severe complication in patients with advanced liver cirrhosis Eur J Clin Microbiol Infect Dis, 33(2), pp 259-64 112 Gravito-Soares, M., et al (2017), Spontaneous fungal peritonitis: a rare but severe complication of liver cirrhosis Eur J Gastroenterol Hepatol, 29(9), pp 1010-1016 113 Tobias Lahmer , A.B (2016) Fungal Peritonitis: Underestimated Disease in Critically Ill Patients with Liver Cirrhosis and Spontaneous Peritonitis.Journals.plos.org., 11(7) 114 Fiore, M and S Leone, (2016) Use of antifungals in critically ill cirrhotic patients with spontaneous peritonitis J Hepatol, 64(4), pp 986-7 115 Retamar, PP., et al (2013) Impact of the MIC of Piperacillin-Tazobactam on the Outcome of Patients with Bacteremia Due to Extended-Spectrum-Lactamase-Producing Escherichia coli Antimicrobial Agents and Chemotherapy, 57(7), pp 3402-3404 116 Leone, S., et al (2014) Comment on "Management of infections in cirrhotic patients: report of a consensus conference" S Fagiuoli et al Dig Liver Dis, 46(6), pp 573-4 117 Dever, J.B and M.Y Sheikh,(2015) Review article: spontaneous bacterial peritonitis bacteriology, diagnosis, treatment, risk factors and prevention Aliment Pharmacol Ther, 41(11), pp 1116-31 118 Tamma, PP.D and J Rodriguez-Bano, (2017).The Use of Noncarbapenem beta-Lactams for the Treatment of Extended-Spectrum beta-Lactamase Infections Clin Infect Dis, 64(7), pp 972-980 119 Gould, I.M (2013) Treatment of bacteraemia: meticillin-resistant Staphylococcus aureus (MRSA) to vancomycin-resistant S aureus (VRSA) Int J Antimicrob Agents, 42 Suppl: pp S17-21 120 Ippolito, G., et al (2010) Methicillin-resistant Staphylococcus aureus: the superbug Int J Infect Dis, 14 Suppl 4: pp S7-11 121 Nathwani, D (2005) Tigecycline: clinical evidence and formulary positioning Int J Antimicrob Agents, 25(3), pp 185-92 122 Moise, PP.A., et al (2009) Susceptibility relationship between vancomycin and daptomycin in Staphylococcus aureus: facts and assumptions Lancet Infect Dis, 9(10), pp 617-24 123 Leone, S., et al (2015) Methicillin-resistant Staphylococcus aureus infections: role of daptomycin/beta-lactams combination Infez Med, 23(2), pp 99-104 124 Jalan, R., et al (2009) Alterations in the functional capacity of albumin in patients with decompensated cirrhosis is associated with increased mortality Hepatology, 50(2), pp 555-64 125 Herrmann, F.R., et al (1992) Serum albumin level on admission as a predictor of death, length of stay, and readmission Arch Intern Med, 152(1), pp 125-30 126 Sigal, S.H., et al (2007) Restricted use of albumin for spontaneous bacterial peritonitis Gut, 56(4), pp 597-9 127 Fong, T.L., et al (1989) Polymorphonuclear cell count response and duration of antibiotic therapy in spontaneous bacterial peritonitis Hepatology, 9(3), pp 423-6 128 Fernandez, J., et al (2007) Primary prophylaxis of spontaneous bacterial peritonitis delays hepatorenal syndrome and improves survival in cirrhosis Gastroenterology, 133(3), pp 818-24 129 Terg, R., et al (2008) Ciprofloxacin in primary prophylaxis of spontaneous bacterial peritonitis: a randomized, placebo-controlled study J Hepatol, 48(5), pp 774-9 130 Singh, N., et al (1995) Trimethoprim-sulfamethoxazole for the prevention of spontaneous bacterial peritonitis in cirrhosis: a randomized trial Ann Intern Med, 122(8), pp 595-8 131 Hanouneh, M.A., et al (2012) The role of rifaximin in the primary prophylaxis of spontaneous bacterial peritonitis in patients with liver cirrhosis J Clin Gastroenterol, 46(8), pp 709-15 132 Nguy n V n Kính, L.N.K.v.c (2009) Báo cáo s d ng kháng sinh kháng kháng s inh t i 15 bênh vi n Vi t Nam n m 2008-2009 Báo cáo c a B Y t Vi t Nam ph i h p v i D án H p tác toàn c u v kháng kháng sinh GARP- Vi t Nam., 133 Nguy n V n Kính cs (2015), S d ng kháng sinh kháng kháng sinh t i Vi t Nam T p chí h i truy n nhi m Vi t Nam, pp 33-34 134 Umgelter, A., et al (2009) Failure of current antibiotic first-line regimens and mortality in hospitalized patients with spontaneous bacterial peritonitis Infection, 37(1), pp 2-8 135 Alexopoulou, A., et al (2013) Increasing frequency of gram-positive cocci and gram-negative multidrug-resistant bacteria in spontaneous bacterial peritonitis Liver Int, 33(7), pp 975-81 136 Acevedo, J 2015) Multiresistant bacterial infections in liver cirrhosis: Clinical impact and new empirical antibiotic treatment policies World J Hepatol, 7(7), pp 916-21 137 Merli, M., et al (2015) The spread of multi drug resistant infections is leading to an increase in the empirical antibiotic treatment failure in cirrhosis: a prospective survey PLoS One, 10(5), pp e0127448 138 Cholongitas, E.PP GV; Vangeli, M; Terreni, (2005) Systematic review: The model for end-stage liver disease should it replace ChildPugh's classification for assessing prognosis in cirrhosis? Alimentary pharmacology & therapeutics 22(11-12), pp 1079-1089 139 Wani, Z.A., et al (2015) Gastric varices: Classification, endoscopic and ultrasonographic management Journal of Research in Medical Sciences : The Official Journal of Isfahan University of Medical Sciences, 20(12), pp 1200-1207 140 Abby Philips, C and A Sahney, (2016).Oesophageal and gastric varices: historical aspects, classification and grading: everything in one place Gastroenterology Report, 4(3), pp 186-195 141 Sarin, S.K., et al (1992) Prevalence, classification and natural history of gastric varices: a long-term follow-up study in 568 portal hypertension patients Hepatology, 16(6), pp 1343-9 142 Vilstrup, H., et al (2014) Hepatic encephalopathy in chronic liver disease: 2014 Practice Guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver Hepatology, 60(2), pp 715-35 143 Montagnese, S., et al (2011) Different biochemical correlates for different neuropsychiatric abnormalities in patients with cirrhosis Hepatology, 53(2), pp 558-66 144 Arroyo, V., et al (1996) Definition and diagnostic criteria of refractory ascites and hepatorenal syndrome in cirrhosis International Ascites Club Hepatology, 23(1), pp 164-76 145 Salerno, F., et al (2007) Diagnosis, prevention and treatment of hepatorenal syndrome in cirrhosis Gut, 56(9), pp 1310-8 146 Moore, K.PP and G.PP Aithal, (2006) Guidelines on the management of ascites in cirrhosis Gut, 55(Suppl 6), pp vi1-vi12 147 Heo, J., et al (2009) Clinical features and prognosis of spontaneous bacterial peritonitis in korean patients with liver cirrhosis: a multicenter retrospective study Gut Liver, 3(3), pp 197-204 148 Na, H.Y., et al (2017) Clinical Features of Spontaneous Bacterial Peritonitis: A 10-year Experience from a Single Center Korean J Gastroenterol, 69(2), pp 129-134 149 Hung, T.H., et al (2015) The long-term mortality of spontaneous bacterial peritonitis in cirrhotic patients: A 3-year nationwide cohort study Turk J Gastroenterol, 26(2), pp 159-62 150 Oey, R.C., et al (2018) Microbiology and antibiotic susceptibility patterns in spontaneous bacterial peritonitis: A study of two Dutch cohorts at a 10-year interval United European Gastroenterol J, 6(4), pp 614-621 151 Thiele, G.B., et al (2014) Clinical and laboratorial features of spontaneous bacterial peritonitis in southern Brazil Sao Paulo Med J, 132(4), pp 205-10 152 Lê Thanh Qu nh Ngân cs (2017) Kh o sát viêm phúc m c nhi m khu n t phát c i m vi trùng h c b nh nhân x gan.T p chí khoa h c tiêu hóa Vi t nam, 48: pp 3046-3056 153 H Xuân Th cs (2011) Ch n oán vi trùng h c viêm phúc m c nguyên phát vi trùng b nh nhân x gan c tr H i ngh khoa ho c B nh vi n nhân dân Gia 154 ng Báo cáo toàn v n nh pp 107-113 ng Quang Nam, V n Long, cs., (2016) ánh giá hi u qu s an toàn c a tiêm Histoacryl qua n i soi búi giãn t nh m ch phình v b nh nhân x gan T p chí khoa h c tiêu hóa Vi t nam, 43: pp 2698-2705 155 Ph m Khánh H ng, V Tr ng Khanh, V n Long, cs.,(2016) ánh giá k t qu th t t nh m ch tâm v - th c qu n b nh nhân x gan T p chí khoa h c tiêu hóa Vi t nam., 43: pp 2725-2731 156 Nguy n Th Chi, Ph m Th Thu H cs, (2009) Nh n xét lâm sàng, c n lâm sàng giá tr c a hai ph tr ng ch n oán nhi m trùng d ch c tr c i m ng pháp c y d ch c ng b nh nhân x gan T p chí khoa h c tiêu hóa Vi t nam 14: pp 957-962 157 Navasa, M., et al.,(1996) Randomized, comparative study of oral ofloxacin versus intravenous cefotaxime in spontaneous bacterial peritonitis Gastroenterology, 111(4), pp 1011-7 158 Nguy n Th Vân Anh, ng Th Kim Oanh cs, (2007).Nghiên c u tình tr ng nhi m trùng d ch c tr nghiên c u y h c, B Y t - ng b nh nhân x gan T p chí i h c Y Hà N i., 53(5), pp 34-37 159 Cheong, H.S., et al., (2009) Clinical significance and outcome of nosocomial acquisition of spontaneous bacterial peritonitis in patients with liver cirrhosis Clin Infect Dis, 48(9), pp 1230-6 160 Terg, R., et al., (2009).Serum creatinine and bilirubin predict renal failure and mortality in patients with spontaneous bacterial peritonitis: a retrospective study Liver Int, 29(3), pp 415-9 161 Jun, B.G., et al., (2018) Follow-up Creatinine Level Is an Important Predictive Factor of In-hospital Mortality in Cirrhotic Patients with Spontaneous Bacterial Peritonitis J Korean Med Sci, 33(12), pp e99 162 Guevara, M., et al., (2012) Albumin for bacterial infections other than spontaneous bacterial peritonitis in cirrhosis A randomized, controlled study J Hepatol, 57(4), pp 759-65 163 Thevenot, T., et al., (2015) Effect of albumin in cirrhotic patients with infection other than spontaneous bacterial peritonitis A randomized trial J Hepatol, 62(4), pp 822-30 164 Reginato, T.J., et al., (2011) Characteristics of ascitic fluid from patients with s uspected spontaneous bacterial peritonitis in emergency units at a tertiary hospital Sao Paulo Med J, 129(5), pp 315-9 165 Riggio, O and S Angeloni, (2009) Ascitic fluid analysis for diagnosis and monitoring of spontaneous bacterial peritonitis World Journal of Gastroenterology : WJG, 15(31), pp 3845-3850 166 Nousbaum, J.B., et al., (2007).Diagnostic accuracy of the Multistix SG reagent strip in diagnosis of spontaneous bacterial peritonitis Hepatology, 45(5), pp 1275-81 167 Karvellas, C.J., et al., (2015) Appropriate and timely antimicrobial therapy in cirrhotic patients with spontaneous bacterial peritonitisassociated septic shock: a retrospective cohort study Aliment Pharmacol Ther, 41(8), pp 747-57 168 Sajjad, M., Z.A Khan, and M.S Khan, (2016) Ascitic Fluid Culture in Cirrhotic Patients with Spontaneous Bacterial Peritonitis J Coll Physicians Surg Pak, 26(8), pp 658-61 169 A De, S.B.a.S.B., (2014) Comparison of three culture methods for diagnosis of Spontaneous Bacterial Peritonitis (SBP) in adult patients with cirrhosis Int.J.Curr.Microbiol.Appp.Sci., 3(7), pp 156-160 170 Castellote, J., et al., (1990) Comparison of two ascitic fluid culture methods in cirrhotic patients with spontaneous bacterial peritonitis Am J Gastroenterol, 85(12), pp 1605-8 171 Song, H.G., et al., (2002) [Clinical and microbiological characteristics of spontaneous bacterial peritonitis (SBP) in a recent five year period] Taehan Kan Hakhoe Chi, 8(1), pp 61-70 172 Obstein, K.L., et al., (2007) Association between model for end-stage liver disease and spontaneous bacterial peritonitis Am J Gastroenterol, 102(12), pp 2732-6 173 Jepsen, PP., et al., (2003).Prognosis of patients with liver cirrhosis and spontaneous bacterial peritonitis Hepatogastroenterology, 50(54), pp 2133-6 174 El Sayed Zaki, M., et al., (2011).The high prevalence of Listeria monocytogenes peritonitis in cirrhotic patients o f an Egyptian Medical Center J Infect Public Health, 4(4), pp 211-6 175 Campillo, B., et al., (2002) Nosocomial spontaneous bacterial peritonitis and bacteremia in cirrhotic patients: impact of isolate type on prognosis and characteristics of infection Clin Infect Dis, 35(1), pp 1-10 176 Groszmann, R.J., et al (2005) Beta-blockers to prevent gastroesophageal varices in patients with cirrhosis N Engl J Med, 353(21), pp 2254-61 177 Merli, M., et al., (2003) Incidence and natural history of small esophageal varices in cirrhotic patients J Hepatol, 38(3), pp 266-72 178 Bosch, J., et al., (2008) Recombinant factor VIIa for variceal bleeding in patients with advanced cirrhosis: A randomized, controlled trial Hepatology, 47(5), pp 1604-14 179 Bosch, J and J.C Garcia-Pagan, (2003) Prevention of variceal rebleeding Lancet, 361(9361), pp 952-4 180 Gunjaca, I and I Francetic, (2010) Prevalence and clinical outcome of spontaneous bacterial peritonitis in hospitalized patients with liver cirrhosis: a prospective observational study in central part of Croatia Acta Clin Croat, 49(1), pp 11-8 181 Garcia-Tsao, G and J Bosch, (2010) Management of varices and variceal hemorrhage in cirrhosis N Engl J Med, 362(9), pp 823-32 182 Low, G., G.J.M Alexander, and D.J Lomas, (2015) Hepatorenal Syndrome: Aetiology, Diagnosis, and Treatment Gastroenterology Research and Practice, pp 207012 183 Gines, A., et al (1993) Incidence, predictive factors, and prognosis of the hepatorenal syndrome in cirrhosis with ascites Gastroenterology, 105(1), pp 229-36 184 Salerno, F., et al (2011) Diagnosis, treatment and survival of patients with hepatorenal syndrome: a survey on daily medical practice J Hepatol, 55(6), pp 1241-8 185 Follo, A., et al (1994) Renal impairment after spontaneous bacterial peritonitis in cirrhosis: incidence, clinical course, predictive factors and prognosis Hepatology, 20(6), pp 1495-501 186 Wadei, H.M., et al (2006) Hepatorenal syndrome: pathophysiology and management Clin J Am Soc Nephrol, 1(5), pp 1066-79 187 Navasa, M., et al (1998) Tumor necrosis factor and interleukin-6 in spontaneous bacterial peritonitis in cirrhosis: relationship with the development of renal impairment and mortality Hepatology, 27(5), pp 1227-32 188 Papp-Wallace, K.M., et al (2011) Carbapenems: Past, Present, and Future Antimicrobial Agents and Chemotherapy, 55(11), pp 49434960 189 Felisart, J., et al (1985) Cefotaxime is more effective than is ampicillintobramycin in cirrhotics with severe infections Hepatology, 5(3), pp 457-462 ... c hi n sàng, c n lâm sàng k t qu phát tài: “M t s c hi u bi t c i m lâm i u tr viêm màng b ng nhi m khu n t b nh nhân x gan nh m m c tiêu: + Mô t c i m lâm sàng, c n lâm sàng b nh Viêm màng b... th y x gan th t s v n Vi t Nam 1.2 Nh ng nguyên nhân g y x gan Có nhi u nguyên nhân g y x gan: s c kh e báo ng t i + Các nguyên nhân th - B nh gan r ng g p g y x gan u, bia - Nhi m virus viêm gan. .. Tri u ch ng lâm sàng, c n lâm sàng ng x gan [46] b nh nhân x gan 1.4.1 Tri u ch ng lâm sàng Các tri u ch ng lâm sàng bi u hi n ph thu c vào giai o n x gan n n b nh lý gan m n tính X gan có giai