连续性血液透析滤过联合腹水浓缩回输治疗肝肾综合征的研究

Treatment of hepatorenai syndrome with continuous hemodiafiltration plus reinfusion of concentrated ascitic fluid

目的探讨连续性血液透析滤过联合腹水浓缩回输治疗肝肾综合征的疗效。方法选取27例肝肾综合征并大量腹水患者，采用连续性血液透析滤过联合腹水浓缩回输治疗，比较治疗前、后患者的体质量、腹围、尿量、血浆内皮素1、血浆血管紧张素Ⅱ、清蛋白、血肌酐、尿素氮、血碳酸氢根以及患者的精神、饮食等一般情况变化。结果采用联机连续性血液透析滤过联合腹水浓缩回输治疗后，患者血肌酐、尿素氮、血浆内皮素1及血浆血管紧张素Ⅱ明显下降，酸中毒和低钠血症得到纠正，清蛋白升高，体质量、腰围明显缩小，尿量增加。结论该疗法可降低肝肾综合征并发症，提高生存率。

Objective To study the clinical efficacy of continuous hemodiafiltration plus reinfusion of concentrated ascitic fluid in the treatment of patients with hepatorenal syndrome. Methods Twenty-seven patients with hepatorenal syndrome and ascites were treated with continuous hemodiafiltration plus reinfusion of concentrated ascitic fluid. The change of the body weight, abdomen circumference, urine volume, endothelin-1 （ET-1）, plasma angiotension- Ⅱ （Ang- Ⅱ ）, serum albumin, serum creatinine（SCr）, blood urea nitrogen（BUN）, blood sodium（Na^＋ ）, blood HCO3- （HCO3^-） and the condition about spirit, drink and food were observed and compared. Results After treatment of continuous hemodiafiltration plus reinfusion of concentrated ascitic fluid, SCr, BUN, ET-1, Ang-Ⅱ , body weight and abdomen circumference were decreased obviously, hyponatremia and metabolic acidosis were retrieved, serum albumin and urine volume increased. Conclusions Hemodiafiltration plus reinfusion of concentrated ascitic fluid has been proved safely and effectively in the treating the patients with hepato- renal syndrome,and can improve the survival rate of the patients.