Diagnosticul peritoniteibacteriene spontane

Catalina Olaru-Stavila; Eugen Tcaciuc; Denis Ardeleanu

Diagnosticul peritoniteibacteriene spontane

Autori

Catalina Olaru-Stavila Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu“ https://orcid.org/0009-0005-3524-427X
Eugen Tcaciuc Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu“ https://orcid.org/0000-0002-2362-1788
Denis Ardeleanu Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu“ https://orcid.org/0009-0007-1353-4932

Cuvinte cheie:

peritonită bacteriană spontană, ciroza hepatică, paracenteză

Rezumat

Peritonita bacteriană spontană (PBS) reprezintă o complicație severă a cirozei hepatice decompensate. Cu toate că diagnosticul standardizat, tabloul clinic sunt bine cunoscute, se atestă o întârziere în depistarea PBS care sporește riscul de mortalitate în rândul pacienților. Ne-am propus elaborarea unei revizii de literatură cu relevarea metodelor moderne și clasice utilizate în diagnosticul PBS. Materiale și metode. Pentru realizarea scopului propus au fost analizate lucrări naționale și internaționale privind diagnosticul PBS, folosind motorul de căutare Google Academic, bazele de date PubMed și ScienceDirect (Elsevier). Rezultate. Diagnosticul standardizat este bazat pe determinarea >250 polimorfonucleare/ mm3 (PMN) în lichidul de ascită cu sau fără cultură pozitivă. Vigilența clinică este esențială în identificarea pacienților cu risc sporit de PBS, precum cei cu proteina scăzută în lichidul de ascită, istoric de hemoragie digestivă superioară (HDS), administrarea inhibitorilor pompei de protoni. Se recomandă efectuarea paracentezei diagnostice în primele 6 ore de la spitalizare tuturor pacienților cu ciroză și ascită, cu precădere bolnavilor cu istoric recent de HDS, encefalopatie, injurie renală acută, cu progresia insuficienței hepatice. Au fost propuse un șir de scoruri simple și markeri utili în depistarea PBS, precum procalcitonina, Il-6, lactoferina, calprotectina, testul cu reagent de esterază leucocitară cu perspectivă în simplificarea și accelerarea diagnosticului. Concluzii. Paracenteza diagnostică și numărarea PMN reprezintă standardul de aur pentru confirmarea PBS. În pofida performanțelor bune, markerii non-invazivi și testele rapide nu și-au demonstrat aplicabilitatea în diagnosticul PBS. Este necesară continuarea studiilor clinice pentru validarea acestora.

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Descărcări

Publicat

17.04.2026

Număr

Nr. 4(97) (2023): Supliment. Al V-lea Congres Național de Gastroenterologie și hepatologie din Republica Moldova

Secțiune

Articles

Licență

Această lucrare este licențiată în temeiul Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Cum cităm

[1]

Olaru-Stavila, C. et al. 2026. Diagnosticul peritoniteibacteriene spontane. Sănătate Publică, Economie şi Management în Medicină. 4(97) (Apr. 2026), 40–47.