大量白蛋白、利尿剂联合腹腔穿刺放腹水治疗难治性肝硬化腹水的效果观察  

Efficacy of massive albumin,diuretics combined with abdominocentesis ascites in the treatment of refractory liver cirrhosis and ascites

作　　者：孟娜娜 薛世明 李白杨 李文哲 田露妮 Meng Nana;Xae Shiming;Baiyang;Li Wenzhe;Tian Luni(Department of Gastroenterology,the first people's Hospital of Lin gbao City,Lingbao 472500,China)

机构地区：[1]灵宝市第一人民医院消化内科,河南灵宝472500

出　　处：《中国临床实用医学》2021年第3期40-43,共4页China Clinical Practical Medicine

摘　　要：目的:研究大量白蛋白、利尿剂联合腹腔穿刺放腹水治疗难治性肝硬化腹水的效果观察。方法:选取2017年5月至2020年1月灵宝市第一人民医院消化内科收治的96例难治性肝硬化腹水患者,男45例,女51例,年龄(43.41±2.54)岁,年龄范围为40~50岁。根据治疗方式不同分为腹腔穿刺组(n=52)和联合治疗组(n=44),腹腔穿刺组接受腹腔穿刺放腹水治疗,联合治疗组在腹腔穿刺组的基础上联合大量白蛋白和利尿剂治疗。比较两组患者治疗前与治疗2周后腹水深度、体质量、腹围、肾功能及临床治疗效果、不良反应发生情况。结果:治疗2周后,腹腔穿刺组腹水深度[(6.59±0.61)cm]、体质量[(62.42±5.13)kg]、腹围[(89.11±5.24)cm]均低于治疗前[(7.42±1.14)cm、(67.32±5.35)kg、(98.14±5.49)cm],联合治疗组腹水深度[(5.04±0.54)cm]、体质量[(53.09±5.14)kg]、腹围[(81.12±5.32)cm]均低于治疗前[(7.23±1.21)cm、(67.23±5.11)kg、(98.55±5.38)cm],且联合治疗组均低于腹腔穿刺组;腹腔穿刺组血尿素氮[(9.04±1.25)mmol/L]、血肌酐[(112.42±5.61)μmol/L]均低于治疗前[(10.74±1.68)mmol/L、(135.19±5.21)μmol/L],联合治疗组血尿素氮[(7.24±1.18)mmol/L]、血肌酐[(100.10±5.58)μmol/L]均低于治疗前[(10.89±1.74)mmol/L、(135.23±5.11)μmol/L],且联合治疗组均低于腹腔穿刺组,差异均有统计学意义(P<0.001)。联合治疗组总有效率[97.7%(43/44)]高于腹腔穿刺组[86.5%(45/52)]、不良反应发生率[4.5%(2/44)]低于腹腔穿刺组[19.2%(10/52)],差异均有统计学意义(P<0.05)。结论:大量白蛋白、利尿剂联合腹腔穿刺放腹水治疗难治性肝硬化腹水临床治疗效果较高,能够有效改善患者腹水深度、腹围和肝功能,且安全性较高。Objective:To study the efficacy of massive albumin, diuretics combined with abdominocentesis for ascites to treat refractory liver cirrhosis ascites.Methods:A total of 96 patients with refractory cirrhosis and ascites admitted to the department of Gastroenterology in the first people′s Hospital of Lingbao City from May 2017 to January 2020 were selected, including 45 males and 51 females, aged(43.41±2.54)years old, ranging from 40 to 50 years old.According to different treatment methods, they were divided into abdominal puncture group( n=52)and combined treatment group( n=44). The abdominal puncture group received abdominal puncture and ascites treatment, and the combined treatment group was combined with a large amount of albumin and diuresis on the basis of the abdominal puncture group.The depth of ascites, body weight, abdominal circumference, liver function, clinical treatment effect and adverse reactions were compared between the two groups of patients before treatment and 2 weeks after treatment. Results:Two weeks after treatment, the depth of ascites[(6.59±0.61)cm], body mass index[(62.42±5.13)kg], and abdominal circumference[(89.11±5.24)cm]of the abdominal puncture group were lower than before treatment[(7.42±1.14))cm, (67.32±5.35)kg, (98.14±5.49)cm]. Depth of ascites[(5.04±0.54)cm], body mass index[(53.09±5.14)kg], and abdominal circumference[(81.12±5.32)cm]in the combined treatment group were all lower than before treatment[(7.23±1.21)cm, (67.23 ±5.11)kg, (98.55±5.38)cm], and the combined treatment group was lower than the abdominal puncture group.In the abdominal puncture group, the blood urea nitrogen[( 9.04±1.25)mmol/L]and blood creatinine[(112.42±5.61)μmol/L]were lower than before treatment[(10.74±1.68)mmol/L, (135.19±5.21)μmol/L];in the combined treatment group, blood Urea nitrogen[(7.24±1.18)mmol/L]and blood creatinine[(100.10±5.58)μmol/L]were lower than before treatment[(10.89±1.74)mmol/L, (135.23±5.11)μmol/L];the combined treatment group was lower than the abdominal pu

关 键 词：白蛋白 利尿剂 腹腔穿刺 难治性肝硬化 腹水 

分 类 号：R575.2[医药卫生—消化系统]