腹水回输体内浓缩法治疗血液透析病人的腹水

Treatment of ascites in patients undergo hemodialysis by reinfusion of ascites through innercorporeal concentrating method

:[目的 ] 探讨腹水回输体内浓缩法的疗效、安全性。 [方法 ] 对 4例尿毒症血液透析 (血透 )伴有顽固性腹水的病人进行 6 2次腹水直接回输至血透的体外循环中 ,经血透超滤、浓缩腹水。 [结果 ] 腹水回输前后血浆总蛋白分别为 6 5 .70± 11.70 g/L和 82 .5 0± 11.38g/L(P <0 .0 1) ,白蛋白分别为 2 3 .0 0± 2 .38g/L和 33.80± 8.0 3g/L(P <0 .0 1) ,球蛋白分别为 35 .6 0± 11.47g/L和 46 .17± 5 .92 g/L(P <0 .0 1)。血清肌酐 (scr)和尿素氮 (BUN)的下降率分别为 6 5 .47± 1.2 6 %和 6 8.40± 1.86 %。腹水回输量 2 0 0 0～ 5 0 0 0mL/次。不良反应有血性腹水、管路反应、一过性容量负荷过重 ,不影响治疗继续进行。 [结论 ] 本方法血透和腹水回输同步进行 ,同时达到清除氮质代谢产物和腹水浓缩回输的目的 ,有效。

Objective] To explore the security and effectiveness of reinfusion of ascites by innercorporeal concentrating method.[Methods] Reinfusion of concentrated ascites to the patients blood circulation by ultrafiltration was used to treat 4 patients undergo hemodialysis refractory ascites.[Results] Before reinfusion of ascites,the plasma total protein,albumin and globulin were 65.70±11.70g/L,23.00±2.38g/L and 33.80±8.03g/L respectively, they were 82.50±11.38g/L,33.80±8.03g/L and 46.17±5.92g/L after reinfusion of ascites, which were statistically significant(P<0.01).The reduction rate of serum creatinine and blood urea nitrogen were 65.47±1.26% and 68.40±1.86% respectively. Total volume of reinfusion of ascites was 2～5 L each time. Bloody ascites, reaction of tubing or transitory volume overload occurred in some patients duing the treatment, and were corrected that the treatment need not be terminated.[Conclusion] The results indicate that the therapy is safe and effective to treat patients undergo hemodialysis with refractory ascites.