腹水超滤浓缩腹腔回输联合周期性白蛋白输注治疗顽固性腹水的效果观察  

Efficacy of ascites ultrafiltration and peritoneal reinfusion combined with regular infusion of albumin in treatment of refractory ascites

作　　者：王新亭[1] 张传雷[1] 陈晓琦[1] 冀爱英[1] 陈欣菊[1] WANG Xin-ting;ZHANG Chuan-lei;CHEN Xiao-qi(Department of Gastro-enterology,the First Affiliated Hospital of Henan University of Traditional Chinaese Medicine,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学第一附属医院消化内科,郑州450000

出　　处：《中国临床新医学》2018年第6期554-558,共5页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：目的观察自体腹水超滤浓缩腹腔回输联合周期性白蛋白输注治疗顽固性腹水的效果。方法40例顽固性腹水按治疗方式不同分为腹水回输组和特利加压素组,两组同时给予白蛋白输注。观察并比较两组患者治疗7 d后体重、腹围、24 h尿量变化及短期及长期腹水控制率,并对腹水回输组1、2、3年生存率记录分析。结果腹水回输组患者治疗7 d后较治疗前体重[(66.9±3.3)kg vs(69.6±3.0)kg,P<0.05]及腹围[(92.9±6.9)cm vs(101.0±5.5)cm,P<0.01)]明显下降,尿量明显增加[(1523.6±178.2)ml vs(880.5±124.1)ml,P<0.01],而特利加压素组治疗前后变化差异无统计学意义(P>0.05)。腹水回输组患者短期腹水控制率为90%,而特利加压素组为10%,两组比较差异有统计学意义(P<0.01)。腹水回输组患者长期腹水控制率为90%,而特利加压素组为0%,差异有统计学意义(P<0.01)。腹水回输组患者的1、2、3年生存率分别为100%、95%及80%。结论腹水超滤浓缩腹腔回输联合周期性白蛋白输注治疗顽固性腹水临床效果显著,应用安全,值得进一步推广应用。Objective To evaluate the clinical efficacy of ascites ultrafiltration and peritoneal reinfusion combined with regular infusion of albumin in treatment of refractory ascites. Methods 40 patients with refractory ascites were divided into ascites ultrafiltration group and peritoneal reinfusion group. Both of the two groups were given albumin infusion. The changes of body weight,abdominal circumference,24 h urine output and short-term and longterm ascites control rates were compared between the two groups,and the nutritional status of the patients and the 1,2,3-year overall survival rates were observed. Results The body weight[（ 66. 9 ± 3. 3） kg vs（ 69. 6 ± 3. 0） kg,P〈0. 05] and abdominal circumference[（ 92. 9 ± 6. 9） cm vs（ 101. 0 ± 5. 5） cm,P〈0. 01]were significantly decreased after 7 days of treatment,and the urine output[（ 1523. 6 ± 178. 2） ml vs（ 880. 5 ± 124. 1） ml,P〈0. 01]were significantly increased in the peritoneal reinfusion group,but there were no significant differences before and after the treatment in the ascites ultrafltration group（ P〈0. 05）. The short-term ascites control rates were 90% and 10% in the peritoneal reinfusion group and the ascites ultrafltration group,respectively,the long-term ascites control rates were90% and 0% in them,respectively,with a significant difference between the two groups（ P〈0. 01）. The 1,2,and3 year survival rates were 100%,95%,and 80% in the peritoneal reinfusion group,respectively. Conclusion Ascites ultrafiltration and peritoneal reinfusion combined with regular infusion of albumin is safe and effective in treatment of refractory ascites.

关 键 词：肝硬化 顽固性腹水 腹水浓缩回输 营养不良 

分 类 号：R575.2[医药卫生—消化系统]