64例肝硬化难治性腹水的疗效分析  

Effect of large volume paracentesis associated with intravenous infusion of albumin and dextran 40 in refractory ascites due to cirrhosis

作　　者：肖南平[1] 张仕泽[2] 谭柯[3] 

机构地区：[1]四川大学华西医院消化内科,四川成都610041 [2]广元市第一人民医院消化科,四川广元6280171 [3]四川大学华西公共卫生学院卫生统计教研室,四川成都610041

出　　处：《现代医药卫生》2008年第13期1902-1904,共3页Journal of Modern Medicine & Health

摘　　要：目的:探讨大量腹腔放液术(large volume paracentesis,LVP)联合静脉滴注白蛋白、右旋糖酐40治疗肝硬化难治性腹水的临床疗效和安全性。方法:肝硬化难治性腹水患者64例,随机分成两组,研究组36例采用LVP联合静脉滴注白蛋白、右旋糖酐40治疗,对照组28例采用传统的利尿剂联合静脉滴注白蛋白治疗。以3周为1疗程。统计两组患者疗程结束时的疗效以及并发症发生率,比较两组患者住院期间的住院费用、药费、平均住院时间、白蛋白和血制品用量。结果:研究组腹水消退总有效率(94.4%)显著高于对照组(60.7%)(P<0.05);住院期间的的住院费用、药费、平均住院时间、白蛋白和血制品用量研究组明显低于对照组(P<0.05),肝性脑病、肝肾综合征、腹腔感染、电解质紊乱等并发症的发生率两组差异无显著性(P>0.05)。结论:LVP联合静脉滴注白蛋白、右旋糖酐40是治疗肝硬化难治性腹水的一种安全、有效的方法;与传统的利尿剂联合静脉滴注白蛋白相比,住院时间明显缩短,住院费用显著降低。Objective ：To observe the clinical curative effect and safety of large volume paracentesis associated with intravenous infusion of albumin and dextran 40 in refractory ascites due to cirrhosis, Methods：64 patients with cirrhotic refractory aseites were randomly divided into two groups. The study group （n=36） was treated by large volume paracentesis associated with intravenous infusion of albumin and dextran 40 ,while the control group （n=28） received orthodox diuretic agent associated with intravenous infusion of albumin. All the patients were treated for 3 weeks,The therapeutic effect and the incidence rate of complications at the end of 3 weeks and the cost of hospitalization and drug, the in-patient admission days,the dosage of albumin and blood infusion during admission time were compared between the two groups. Results.The therapeutic effect in the study group（94.4%） was better in decreasing ascites than that in the control group （60.7%）（P〈0.05 ）.The cost of hospitalization and drug, the in-patient admission days, the dosage of albumin and blood infusion during admission time in in the study group were obviously less than those in the control group （P〈0.05）;The incidence rates of complications such as hepatic encephalopathy,hepatorenal syndrome,spontaneous bacterial peritonitis,electrolyte disturbances,were no significant difference between two groups （P〉0.05）.Conclusion：Large volume paracentesis associated with intravenous infusion of albumin and dextran 40 is a safe and effective therapy for refractory ascites due to cirrhosis. It is better in decreasing the in-patient admission days and the cost of hospitalization compared with the traditional diuretic agent associated with intravenous infusion of albumin method.

关 键 词：肝硬化顽固性腹水 大量放腹水 右旋糖酐40 

分 类 号：R5[医药卫生—内科学]