体外超滤自体腹腔积液回输联合人血白蛋白或特利加压素治疗肝硬化顽固性腹腔积液效果观察  

Prospective study of human albumin vs terlipressin following reinfusion of ultrafiltrate-ascite fluid in cirrhotic patients with tense ascites

作　　者：钟捷[1] 陈明[1] 程时丹[1] 张曙[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院消化内科,200025

出　　处：《中国综合临床》2007年第12期1081-1083,共3页Clinical Medicine of China

摘　　要：目的评价联合人血白蛋白或特利加压素在体外超滤自体腹腔积液回输中的安全性及其疗效。方法58例接受体外超滤自体腹腔积液回输治疗的肝硬化顽固性腹腔积液患者随机分为2组。白蛋白组联合使用人血白蛋白治疗。特利加压素组联合使用特利加压素治疗。比较2组患者的心率、血压、体重、尿量、血电解质、胆红素、尿素、血浆肾素、醛固酮与白蛋白水平等疗效评价指标。结果2组病例均完成预定治疗。白蛋白组未观察到不良事件,而特利加压素组中有3例出现轻度头痛和腹痛等情况。在心率、血压等安全性指标方面。2组治疗前后差异均无统计学意义(均p>0.05)。24 h尿量、血清白蛋白、体重、血清肾素、醛固酮水平等疗效评价指标,白蛋白组在治疗前后差异均有统计学意义(均p<0.05)。结论体外超滤自体腹腔积液回榆联用人血白蛋白治疗肝硬化顽固性腹腔积液操作安全,疗效确切;尤其在提高血浆白蛋白水平,并通过调节肾素-血管紧张素-醛固酮系统,改善水、钠潴留等方面具有较明显优势。Objective To compare the safety and efficacy of human albumin substitution vs tedipressin following reinfusion of ultrafiltrate-ascite fluid after total paracentesis in cirrhotic patients with tense ascites. Methods 58 cases of liver cirrhosis with tense ascites,who underwent reinfusion of ultrafihrate-ascite fluid after total paracentesis,were randomly divided into albumin group and terlipressin group. The patients in albumin group received human albumin substitution and those in terlipressin group received terlipressin infus;on, The safety parameters including heart rate and blood pressure, the efficacy parameters including daily urine output, plasma electrolyte, bilirubin concentration, plasma concentration as well as the renin-angiotensin-aldosterone level were evaluated before and after treatment, Results All patients completed treatment, and there was no adverse event observed in albumin group, 3 cases in terlipressin group demonstrated mild headache and abdominal pain, There was no significant difference in heart rate and blood pressure between two groups （ P 〉 0. 05 ）, Plasma albumin concentration and daily urine output are significantly higher in albumin group than those in terlipressin group （ P 〈 0. 05 ）, Simultaneously, the renin and aldosterone levels are significantly down-regulated in albumin group than those in terlipressin group, Conclusion Human albumin （ALBURAAS） substitution following reinfusion of uhrafihrate-ascite fluid after total paracentesis is a safe and efficient therapeutic strategy in treating cirrhotic patients with tense ascites. Ablumin substitution might control the water and sodium retention via regulation of renin-angiotensin-aldosterone system.

关 键 词：肝硬化 腹腔积液 超滤回输 人血白蛋白 特利加压素 

分 类 号：R575.2[医药卫生—消化系统]