结肠灌注透析治疗失代偿性肝硬化顽固性腹水及内毒素血症近期疗效分析

Analysis on the short-term curative effect of the colon perfusion dialysis for the decompensated hepatocirrhosis with intractable ascites and endotoxemia

目的研究结肠灌注透析对失代偿性肝硬化顽固性腹水及内毒素血症、高氨血症、低钠血症的治疗效果。方法将55例失代偿性肝硬化顽固性腹水患者随机分为治疗组30例和对照组25例,两组均予限钠、限水、护肝、控制感染等基础治疗,治疗组同时联合结肠灌注透析治疗,比较两组治疗前后各相关指标。结果经治疗后,治疗组尿素氮、鲎试验、血氨、血钠值分别为(8.14±5.75)mmol/L、(0.089±0.044)EU/mL、(58.44±29.47)μmol/L、(134.23±5.76)mmol/L,对照组分别为(13.84±6.54)mmol/L、(0.127±0.098)EU/mL、(90.57±30.46)μmol/L、(128.18±8.16)mmol/L,两组上述各指标比较,差异均有显著性(P<0.05或P<0.01);治疗组腹水治疗好转率为86.67%,对照组为60.00%,两组比较,差异有显著性(P<0.01);治疗组血清丙氨酸转氨酶、血清总胆红素值分别为(57.47±18.97)U/L、(28.41±13.44)μmol/L,对照组分别为(64.14±21.15)U/L、(26.78±14.72)μmol/L,两组上述指标比较,差异均无显著性(P>0.05)。结论结肠灌注透析治疗对失代偿性肝硬化顽固性腹水及内毒素血症、高氨血症、低钠血症均有较好的近期疗效。

Objective To study the curative effect of the colon perfusion dialysis for the decompensated hepatocirrhosis with intractable ascites, endotoxemia , hyperammonemia and hyponatremia. Methods Fifty-five patients with decompensated hepatocirrhosis associated with intractable ascites were divided into two groups , 30 patients were in treatment group and 25 were in control group, both groups received basic treatment, such as restriction of salt and water, protection of liver and control of infection, treatment group were given colon perfusion dialysis at the same time, the relative detection results before and after treatment in both groups were compared. Results After treatment, the value of urea nitrogen, limulus test,blood ammonia, blood natrium in treatment group was （8. 14±5.75） mmol/L, （0. 089 ± 0. 044）EU/mL, （58.44 ± 29. 47）μmol/L and （134. 23 ± 5.76）mmol/L respectively, in control group, the value of the above was （13.84±6. 54）mmol/L, （0. 127± 0. 098）EU/mL, （90. 57±30. 46） /μmol/L and （128. 18 ± 8. 16）mmol/L, respectively, there were significant difference between the respective values （P〈0. 05 or P〈0. 01 ） ; the improvement rate of ascites in treatment group and control group was 86. 67% and 60. 00% respectively, there was significant difference between them （P〈0. 01 ） ; In treatment group, the value of serum alanine transaminase and serum total bilirubin was （57. 47 ± 18. 97）U/L and （28. 41 ± 13.44） μmol/L respectively; in control group, the value was （64. 14±21.15）U/L and （26. 78±14. 72） /μmol/L respectively, there was no significant difference between them（P〉0. 05）. Conclusion Colon perfusion dialysis therapy had good short-term effect on the decompensated hepatocirrhosis with intractable aseites , endotoxemia , hyperammonemia and hyponatremia.