腹水超滤浓缩腹腔回输在顽固性腹水治疗的应用

Application of ultrafiltration and reinfusion into abdominal cavity in treating stubborn ascites

目的探讨腹水超滤浓缩腹腔回输治疗顽固性腹水的疗效及对肾功能的影响。方法60例顽固性腹水患者在基础治疗前提下应用腹水超滤浓缩腹腔回输治疗,并观察治疗前后腹胀缓解、意识、血压变化及腹腔感染情况,内生肌酐清除率(CCr)、血K+、Na+离子浓度及腹水蛋白的变化。结果腹水超滤浓缩腹腔回输治疗可不同程度缓解腹胀,治疗后无病例出现意识障碍、血压不稳定、腹腔感染;对血K+、Na+离子浓度无明显影响;腹水蛋白在连续3次治疗中为升高,之后1周为降低。CCr>50 ml/min的患者可增加肾小球滤过率,CCr≤50 ml/min的患者反而降低肾小球滤过率。结论腹水超滤浓缩腹腔回输操作简单,疗效确切、不良反应相对少,值得临床推广并进一步摸索。

Objective To explore the therapeutic effects of ultrafiltration and reinfusion of ascites to treat stubborn ascites and its influence to renal function in clinic. Methods The based treatment was given, 60 patients adopted ultrafiltration and reinfusion of ascites co ＊real stubborn ascites, meanwhile, distention, consciousness, blood pressure,abdominal infection, endogenous ereatinine clearanee（CCr）, concentration of K＋, Na＋ and ascites proteins were observed before and after the treatment. Results The treatment could mitigate the distention of the patients in different degrees. After the treatment,the abnormality to consciousness, blood pressure and abdominal infection never happened. There was no significant change in the concentration of K＋ , Na＋. The concentration of ascites proteins raised within three continuous treatments, but later decreased within one week. When CCr was above 50 ml/min, the treatment raised the glomerular filtration rate; on the contrary, CCr under 50 ml/min, the glomerular filtration rate decreased. Conclusion Ultrafiltration and reinfusion of ascites in treating stubborn ascites is a simple operating,effective method with based treatment. The side effect of this treatment is relatively less. The long-term curative effect would need further study.