腹水浓缩回输治疗顽固性腹水临床疗效观察  

A curative effect observation of persistent ascites by infusing the ultrafitrate back in to abdominal cavity

作　　者：张一[1] 余叔侃[1] 李明[1] 史宇飞[1] 钟渊斌[1] 王芝花[1] 

机构地区：[1]江西医学院第一附属医院感染科,南昌330006

出　　处：《江西医药》2002年第1期4-6,共3页Jiangxi Medical Journal

摘　　要：目的寻找顽固性腹水新的治疗方法。方法采用腹水超滤治疗机行腹水超滤浓缩腹腔内回输治疗技术,对22例次各型顽固性腹水患者进行持续性密闭式循环回输治疗,一次性超滤腹水2500～7200ml(平均达5400ml),腹围缩小10～20cm平均达10.5cm),体重一F降2.5～8kg(平均5.1kg)。同时分析其临床效果、适应症及不良反应。结果腹水超滤浓缩治疗前后观察患者血清及腹水的电解质、尿素氮、肌酐、总蛋白、胆红素及补体C3的变化,发现超滤浓缩前后内环境稳定,腹水蛋白提高,胆红素略有升高,而超滤后由于一次性超滤腹水平均可达5400ml,迅速缓解了大量腹水引起的压迫症状,明显减轻了患者的痛苦。由于大量蛋白得以回输增加了有效循环血容量,使肾血管压迫缓解、肾血流量增加,尿素氮、肌酐下降,对预防和治疗肝肾综合征起到一定的作用;腹水超滤浓缩在无菌密闭环境下进行,其安全可靠而无副作用。治疗后偶见腹痛与腹压下降、腹水浓缩刺激肠蠕动增加有关,对症处理即可缓解。少数病例出现一过性体温升高可能与操作过程消毒不严有关,术中注意无菌操作即可避免。对近期上消化道出血及高黄疸患者术后易引起再出血及胆红素升高,应慎重考虑。术后腹部加压包扎可预防门静脉扩张引起的消化道出血。结论腹水超滤浓缩腹腔内回输是一种安全可靠。Objective To search a new offective therapeuotics for persistent acites.Methods As-cites ultrafitration treating machine was used to treat various persistent ascites by infusing ascites ultrafitrate back in to abdominal cavity from22pa-tients.The rates of ascites were filtered once from2500～7200ml with the patients (mean5400ml),their abdomen circumference reduced from10～20cm(mean10.5cm),and decreased in weight from2.5～8kg(mean5.1kg)respectively.Clinic curative effects,in-dication and side effects in the cases were anal-ysed simultaneously.Results Before and after treating the patients,electrolytes,urea nitrogen,creati-nine,total protein,cholecythrin,C complement in serum and peritoneal fluid were detected respec-tively.The results showed that the patients's inter-nal-enviroment were kept stable,total protein in as-cites increased,and cholerythrin raised slightly.It al-leviated obviously the sufferings of the patients by laxing the constrictional symptom caused abundance ascites.As a result of the quatity protein infused back in to body,the blood volume of effective cir-clation was improved,the constricts of renal vessel relaxed,the blood stream of kidney raised,urea ni-trogen and creatinine decreased.It takes effect to prevent and cure the hepatorenal syndrome.Con-clus sion Infusing ascites ultrafitrate back in to ab-dominal cavity is effetive therapeuotics for the pa-tient with persistent acites.It is a safe,reliable,sim-ple,and easy to practise method,and can spreadly be used in clinic.

关 键 词：顽固性腹水 腹水浓缩回输 治疗 疗效 

分 类 号：R442.5[医药卫生—诊断学]