难治性腹水的超滤浓缩回输治疗及经济学评价

Outcomes and Economic Evaluation of Patients with Refractory Ascites Treated by Ultrafilter Concentration and Reinfusion

【目的】研究腹水超滤浓缩腹腔回输治疗难治性腹水的临床疗效并进行经济学评价。【方法】采用腹水超滤浓缩腹腔回输治疗难治性腹水38例(治疗组) , 与腹腔穿刺大量放液组43 例(对照组)作比较, 观察并记录两组患者治疗前后腹围、24 h尿量、体重、血液生化指标的变化。统计两组患者出院后的医疗费用及分布特征,分析两组成本-效果比。【结果】两组总有效率相比无显著性差异(P>0.05),显效率相比有显著性差异(P<0.01)。两组治疗后钾、钠、氯、总胆红素无明显变化(P>0.05),治疗组白蛋白含量增高(P<0.01);两组治疗前后腹围、体重、血尿素氮、肌酐清除率下降(P<0.01),24 h 尿量增多(P<0.01);治疗组平均总住院费及床位费下降(P<0.01);治疗组具有更好的经济性。【结论】腹水超滤浓缩腹腔回输治疗难治性腹水安全有效、操作简单, 缩短住院时间、减轻患者经济负担,值得临床推广使用。

ObjectiveTo investigate the therapeutic efficacy and economic analysis of ultrafilter concentration in refractory ascites.There were 38 cases at treatment group(treated with ultrafilter concentration and reinfusion) and 43 cases at control group(treated by repeated large-volume paracentesis), Before and after treating the patients , comparison of abdomen circumferences、total urine volumes of 24 h、body weight biochemical parameters of serum,medical costs and its distributive features was undertaken.The results showed the treatment group's internal-enviroment kept stable,levels of total serum protein increased(P<0.01);levels of abdominal circumference,body weight,BUN and Ccr decreased remarkably(P<0.01) ;total medical costs decreased(P<0.01) in the treatment group. Total effective rate in two groups had no significant difference(P>0.05) ,but excellent rate had significant difference(P<0.01).[Conclusion]Ultrafilter concentration and reinfusion of ascites is a practical ,effective and economical method for treating refractory ascites.