胀消贴联合腹水回输治疗肝硬化顽固性腹水的疗效观察  

Zhangxiaotie combined with ascites ultrafiltration concentration back-transfusion treatment for refractory ascites in patients with cirrhosis

作　　者：祝峻峰[1] 顾宏图[2] 钱平安 李勇[1] 

机构地区：[1]上海中医药大学附属市中医医院肝病科,上海200071 [2]上海中医药大学附属曙光医院肝病科,上海201203 [3]安徽省红十字铜陵医院肝病科,安徽铜陵244000

出　　处：《同济大学学报（医学版）》2012年第5期75-79,共5页Journal of Tongji University(Medical Science)

基　　金：上海市卫生局中医药科研基金(2010I035A)

摘　　要：目的观察胀消贴敷脐联合自身腹水超滤浓缩回输治疗乙肝后肝硬化顽固性腹水的临床疗效。方法选择乙肝后肝硬化顽固性腹水住院患者,治疗组采用胀消贴敷脐联合自身腹水超滤浓缩回输,对照组采用单纯性自身腹水超滤浓缩回输,观察治疗前后患者的症状、体征、血钠、尿钠以及肝功能指标,同时彩色多普勒检测腹水量与门静脉血流量的变化。结果治疗组总有效率为80.0%,对照组总有效率为62.2%,差异有统计学意义(Z=-2.469,P=0.014)。治疗后,治疗组体质量、腹围明显下降,肝功能明显改善,尿量增多,门脉血流量明显下降(P<0.05),而对照组无明显改善(P>0.05)。结论胀消贴敷脐联合自身腹水超滤浓缩回输治疗乙肝后肝硬化顽固性腹水疗效显著。Objective To assess the clinical efficacy and safety of Zhangxiaotie combined with ascites ultrafiltration concentration back-transfusion treatment for refractory ascites in patients with posthepatitis B cirrhosis. Methods Ninety patients with post-hepatitis B cirrhosis complicating refractory ascites received the ascites ultrafiltration concentration back- transfusion treatment and conventional therapy. Zhangxiaotie was applied on the navel in 45 patients （treatment group）, another 45 patients did not use Zhangxiaotie （control group）. Symptoms and signs, serum sodium, urinary sodium and liver function, the volume of ascites and portal blood flow changes were observed before and after treatment in both groups. Results The total effective rate of ascites subsiding was 80.0% in treatment group and 62. 2% in control group （Z=-2.469, P = 0. 014） The weight and abdominal circumference in treatment group decreased significantly, while liver function improved and urine output increased. And portal blood flow was significantly decreased in treatment group （ P 〈 0.05 ）, while there was no significant improvement in control group （P 〈 0.05 ）. Conclusion Zhangxiaotie combined with ascites ultrafiltration concentration back-transfusion treatment is effective for refractory ascites in patients with post-hepatitis B cirrhosis.

关 键 词：胀消贴 敷脐 腹水超滤浓缩回输 乙肝后肝硬化 顽固性腹水 

分 类 号：R657.31[医药卫生—外科学]