腹水浓缩加光疗回输腹腔治疗肝硬变顽固性腹水的研究  

STUDY ON CO-TREATMENT OF ASCITES CONCENTRATION REF- TRACTORY AND LIGHT TRANSMISSION REFUSION TREATMENT FOR REFRACTORY ASCITES OF CIRRHOSIS

作　　者：赵军涛[1] 王丽英[1] 马晓红[1] 张惠琴[1] 王红卫[2] 石鹏辉[2] 

机构地区：[1]河北省保定市传染病医院肝病研究所,071000 [2]河北省保定市传染病医院检验科,071000

出　　处：《实用肝脏病杂志》2000年第4期214-216,共3页Journal of Practical Hepatology

摘　　要：目的 通过自体腹水浓缩光量子载体氧透射回输腹腔治疗肝硬变顽固性腹水,迅速缓解腹水压迫症状,缩短疗程,提高患者的生命质量。方法 将腹水引入血液透析器浓缩,经光量子载体氧透射仪照射,回输至腹腔,以50～250ml/min速度,将腹腔内腹水完全放完为止,用放免法检测腹水回输前后血清肾素(Al)、血管紧张素(All)、醛固酮(ALD)的浓度;腹水原液、终液及滤出液中内毒素定量(合成基质偶氮显色法);回输前后血、腹水及滤液的生化指标。结果 腹水浓缩光量子载体氧透射回输后,腹水压迫症状迅速缓解,浮肿、胸腔积液随之迅速消退,食量增加,腹围由91.93±7.59cm减至81±6.84cm;体重由67.18±11.6kg减至60.26±10.56kg,24小时尿量由1070.83±519ml增至2058.33±883.65ml,滤出液体平均4735ml/次。回输前后呼吸、血压、血法及腹水生化指标无变化;血浆3项激素与正常对照差异显著,但回输前后的变化无明显差异;腹水内毒素水平明显下降,无严重并发症发生。结论 肝硬变顽固性腹水经一般内科治疗无效或合并自发性细菌性腹膜炎的病例,腹水浓缩光量子载体氧透射回输腹腔,是一种暂时有效的治疗方法。Objective Ascites concentration reftractory and light transmission refusion treatment were used for refractory ascites in cirrhosis patients to relieve oppressive symptom,shorten the course of treatment, improve living standard. Methods Ascites was drawn into blood filter tube at a rate of 50-250mlmin-1 .concentrated, radiated by leght transmission machine, drawn into abdominal cavity at last, until ascites disappeared. Blood :renin (AI) 、 angiotensin (AII)、 aldosterone (ALD) were detected by radioimmunoassay at before and after reftractory. Ascites Endotoxin was detected at different stages. Biochemical markers were detemined in blood, ascites and filtrate at different stages. Results After treatment, oppressive symptom relieved. Edema, pleural effusion disappeared rapidly. Eppetite improved. Abdomen measurement reduced from 91. 93±7. 59cm to 81±6. 84cm. Body weight from 67. 18± 11. 6kg to 60. 26±10. 56kg. Urine quantity of 24 hours increased form 1070. 83±519ml to 2058. 33±883. 65ml. The average of filtrate was 4735ml. Breath, blood, pressure, pulse,biochemical markers in blood and ascites didn't change. Five dinds of hormone in plasma were different with normal,but they didn't change obviously after treatment. Ascites Endotoxin dedeased significantly. No serious complication took placd. Conclusion Patients with cirrhosis refractory ascites or complicated spontaneous bacteral peritonitis could be treated by ascites concentration and light transmission refusion treatment,if they weren't susceptible to common intermal therapy.

关 键 词：肝硬变 顽固性腹水 浓缩 光量子载体氧透射 

分 类 号：R575.2[医药卫生—消化系统]