腹水浓缩回输联合头孢哌酮钠舒巴坦钠腹腔注射治疗肝硬化合并腹水感染的临床效果  

Clinical efficacy of concentrated ascites reinfusion combined with intraperitoneal injection of cefoperazone sodium and sulbactam sodium for patients with liver cirrhosis and ascites infection

作　　者：黄鹏 沈秀微 吴淑娟 张芳芳 洪亮 HUANG Peng;SHEN Xiu-wei;WU Shu-juan;ZHANG Fang-fang;HONG Liang(The Third Affiliated Hospital of Wenzhou Medical University , Ruian , Zhejiang 325200, China)

机构地区：[1]温州医科大学附属第三医院药学部,浙江瑞安325200 [2]温州医科大学附属第三医院感染科,浙江瑞安325200

出　　处：《中华医院感染学杂志》2019年第7期984-988,共5页Chinese Journal of Nosocomiology

摘　　要：目的探究腹水浓缩回输联合头孢哌酮钠舒巴坦钠腹腔注射治疗肝硬化合并腹水感染的临床效果。方法选取2014年1月-2016年12月医院收治的128例肝硬化腹水感染的患者作为研究对象;按照随机数字表法分为对照组和干预组,每组64例。对照组患者采用头孢哌酮钠舒巴坦钠腹腔注射治疗,干预组在对照组治疗的基础上加用腹水浓缩回输治疗,连续治疗14d。对两组患者的的临床治疗效果进行评定;记录两组患者临床症状缓解的时间;测定两组患者的肝肾功能相关指标,包括谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)、尿素氮(BUN)及肌酐(Scr);测定两组患者肾素血管紧张素系统相关指标的变化,采用ELISA测定两组患者治疗前后血清中炎症指标的变化,包括肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)及白细胞介素-8(IL-8)的含量,分析两组患者治疗过程中并发症的发生情况。结果干预组患者的临床疗效优于对照组患者,差异有统计学意义(Z=2.373,P=0.018);与对照组患者相比,干预组患者腹泻、腹痛、发热及食欲不振等临床症状缓解的时间均减少(P<0.05);治疗后,两组患者血浆中ALT、AST、TBIL、BUN及Scr含量、肾素、血管紧张素及醛固酮的含量及血清中TNF-α、IL6及IL-8的含量均降低(P<0.05),且与对照组患者相比,干预组患者上述指标均降低(P<0.05);在治疗中,对照组并发症发生率为37.50%,高于干预组患者的12.50%(χ2=10.667,P=0.001)。结论腹水浓缩回输联合头孢哌酮钠舒巴坦钠腹腔注射治疗肝硬化腹水感染具有良好的临床效果,能够改善患者的肝肾功能,降低肾素、血管紧张素、醛固酮、TNF-α、IL6及IL-8的含量,并能够减少并发症的发生。OBJECTIVE To investigate the effect of intraperitoneal injection of cefoperazone sodium and sulbactam sodium in combination with concentrated ascites reinfusion in the treatment of patients with liver cirrhosis and ascites infection. METHODS 128 patients with cirrhosis ascites infection admitted to the hospital from Jan. 2014 to Dec. 2016 were selected as the study subjects. According to the random number table method, they were divided into the control group and the intervention group, with 64 cases in each group. The patients in the control group were treated with intraperitoneal injection of cefoperazone sodium and sulbactam sodium. The intervention group was treated with concentrated ascites reinfusion in addition to the treatment received by the control group, and the treatment lasted for 14 days. The clinical effects of the two groups were evaluated. The time to relieve the clinical symptoms was recorded. The indicators of liver and kidney function, including Alanine aminotransferase (ALT), aspartate transaminase (AST), total bilirubin (TBIL), blood urea nitrogen (BUN) and creatinine (Scr) were determined. Changes in renin-angiotensin system related indicators including contents of renin, angiotensin, and aldosterone were determined. Enzyme-linked immunosorbent assay (ELISA) was used to measure changes in serum inflammatory markers before and after treatment, including tumor necrosis factor-a (TNF-α), interleukin-6 (IL- 6) and interleukin-8 (IL-8) levels. The occurrence of complications of the two groups of patients during the treatment was analyzed. RESULTS The total effective rate of treatment in the intervention group was significantly higher than that in the control group (Z = 2.373,P =0.018). Compared with the control group, the time to relieve the clinical symptoms such as diarrhea, abdominal pain, fever and loss of appetite decreased in the intervention group (P<C0.05). After treatment, the plasma levels of ALT. AST. TBIL, BUN and Scr, renin, angiotensin and aldosterone, and serum levels of TNF-α,

关 键 词：腹水浓缩回输 头孢哌酮钠舒巴坦钠 腹腔注射 肝硬化合并腹水感染 临床效果 

分 类 号：R57[医药卫生—消化系统]