腹水超滤浓缩回输术治疗肝硬化腹水临床分析

Clinical study on the treatment of reinfusion of ultrafiltrate concentrated ascitic fluid

目的观察腹水超滤浓缩回输术治疗肝炎肝硬化顽固性腹水的临床疗效。方法将兰州大学附属白银医院2002年5月至2007年5月肝炎肝硬化合并腹水住院患者76例;随机分为对照组40例和治疗组36例。对照组给予腹腔穿刺放液治疗;治疗组采用腹水超滤浓缩回输治疗。比较两组治疗前后体质量、腹围、尿量的变化,检测电解质、尿素氮、肌酐、胆红素及血清白蛋白指标,并注意观察并发症情况。结果两组治疗后,治疗组在腹围、体质量方面较对照组明显改善(P<0.05),治疗组24h尿量较对照组显著增加(P<0.01);同时,两组组在血清白蛋白、血清肌酐指标上比较有显著性差异(P<0.01或P<0.05),而尿素氮水平无显著性差异(P>0.05)。治疗组显效率和总有效率均优于对照组,差异有显著性(P<0.01)。治疗组并发症发生率低于对照组,差异有显著性(P<0.05)。结论腹水超滤浓缩回输术是治疗肝硬化腹水的一种有效方法,具有操作简便、不良反应及并发症较少特点。

Objective To observe the clinical effect of reinfusion of ultrafihrate concentrated ascitic fluid in patients with hepatitis and liver cirrhosis refractory ascites. Methods Seventy - six in - patients with hepatitis and liver cirrhosis and refractory ascites diagnosed in the Baiyin Hospital of Lanzhou University from May 2002 to May 2007 were divided into treatment group （36 cases） and control group （40 cases）. Patients in control group received paracentesis and patients in treatment group received reinfusion of ultrafiltration concentrated ascites. Changes of body weight, abdominal girth, 24 h urine volume, electrolyte, urea nitrogen, creatinine, bilirubin and serum albumin level and occurrence of complication were compared between the two groups. Results Compared with control group, abdominal girth and body weight in treatment group were improved （ P 〈 0.05 ） , 24 h urine volume was increased （ P 〈 0.01 ） , serum albumin and creatinine level also showed significant differences （ P 〈 0.01 and P 〈 0.05 respectively）. In addition, effective rate of the treatment in treatment group was higher （ P 〈 0.01 ） and complications rate in treatment group was lower （ P 〈0.05 ）. However, urea nitrogen level didnt show significant difference between the two groups（ P 〉0.05 ）. Conclusion Reinfusion of uhrafiltrate concentrated ascitic fluid is an effective treatment for patients with hepatitis and liver cirrhosis refractory ascites.