自体腹水双重滤过净化回输治疗尿毒症顽固性腹水12例

Effect of self-ascitic fluid reinfusion post dual-filtration in uremic refractory ascites:analysis of 12 cases

目的探讨自体腹水双重滤过回输治疗尿毒症顽固性腹水的疗效及安全性。方法采用一次性静脉营养输液袋收集腹水代替置换液,前稀释法进行血液透析滤过治疗尿毒症顽固性腹水,每周2次,观察治疗前后体质量、腹围、腹水B超探测值改变情况,测定血浆白蛋白、肾功能、电解质水平。结果腹水消失3例,有效9例,无效0例。12例患者精神、食欲状况明显好转。结论自体腹水双重滤过治疗尿毒症顽固性腹水操作简单,安全有效,值得推广。

Objective To study the therapeutic effects of self-ascites reinfusion post dual-filtration in patients with refractory ascites. Methods Twelve patients with uremic refractory ascites were treated by pre-dilution hemodiafitration, in which the substitution fluid were replaced by self-ascitic fluid. The changes of body weight,abdominal circumference,B ultrasound detection value ,plasma albumin ,real function and electrolyte level were observed before and after the treatment. Results In these cases,3 patients recovered,9 patients improved. After the reinfusion of self-ascitic fluid,body weight ,abdominal circumference and B ultrasound detection value decreased significantly ,plasma albumin increased significantly （P 〈 0.01）,and there was no significant difference of blood serum electrolyte level （P 〉 0.05） compared with pre-treatment. The reducation rate ofcreatinine and blood urea nitrogen reached 58.79 % ± 3.22 % and 68.02 % ± 2.81%, respectively. Conclusion Selfascitic fluid reinfusion and hemodiafihration could be performed at the meantime ,which provides the dual-effect of ascitic fluid reinfusion and elimination of nitrogen production. Thus this technique is safe and effective in treating patients with uremic refractory ascites,