腹水超滤回输腹腔治疗肝硬化难治性腹水122例临床观察  

Ascites ultrafiltration and reinfusion into abdominal cavity in patients with refractory ascites by cirrhosis:A clinical observation of 122 cases

作　　者：王震凯[1] 汪芳裕[1] 刘炯[1] 施慧[1] 万海军[1] 陆恒[1] 

机构地区：[1]南京军区南京总医院消化内科,南京医学硕士210002

出　　处：《医学研究生学报》2011年第2期172-174,共3页Journal of Medical Postgraduates

基　　金：南京军区南京总医院科研基金(Q2008021)

摘　　要：目的难治性腹水是肝硬化临床终末期的临床表现,临床上药物治疗效果不佳,给患者带来极大痛苦,严重影响生活质量。文中观察腹水超滤回输腹腔术治疗肝硬化难治性腹水的效果及安全性。方法选择122例肝硬化难治性腹水患者,在原治疗基础上增加腹水超滤回输治疗,分别于治疗前后观察患者临床症状、体重、腹围、24 h尿量、血清尿素和肌酐、血清电解质、血清蛋白、尿钠等指标的变化。结果治疗后临床症状明显改善,体重减轻,腹围缩小,尿量增加,尿钠和血清蛋白增高(P<0.05)。血清尿素和肌酐有所下降,但与治疗前比较均无显著性差异(P>0.05),血清电解质亦无明显差异(P>0.05)。122例中,显效56例,有效48例,总有效率85.25%。无一例严重并发症。结论腹水超滤回输腹腔治疗肝硬化难治性腹水安全有效,简便易行。Objective Refractory ascites is clinical manifestation of terminal stage liver cirrhosis.It brings agony and poor quality of life to the patients,because of ineffectiveness in clinical treatment.The present study was to observe the effectiveness and safty of ascites ultrafiltration and reinfusion into abdominal cavity in patients with refractory ascites by cirrhosis.Methods A retrospective study was conducted on 122 liver cirrhosis patients with refractory ascites.Besidesthe routine treatment,all the patients were treated by ascites ultrafiltration.We observed the difference of clinical symptoms,weight,abdominal perimeter,24h urine,serum urea,serum creatinine,electrolytes,serum protein and UNa between pretherapy and post-treament.Results The patients′ clinical symptoms was obviously improved,their abdominal perimeter was diminished,their urine volume,serum protein and UNa raised after the treatment.Though their serum urea and creatinine increased,differerce was no significant between pretherapy and post-treament（P0.05）.So was the difference of serum electrolytes.Among 122 patients,therapeatie effect was excellent in 55 cases,effective in 48 cases,total effective rate was 85.25%.There was no severe complication.Conclusion Ascites ultrafiltration and reinfusion into abdominal cavity is safe,effective and convenient for liver cirrhosis patients with refractory ascites.

关 键 词：腹水超滤回输 肝硬化 难治性腹水 

分 类 号：R657.31[医药卫生—外科学]