中心静脉导管联合高渗葡萄糖治疗肝性胸水的疗效观察

Curative effect of central venous catheter combined with hypertonic glucose in treatment of hepatic hydrothorax

目的观察中心静脉导管联合高渗葡萄糖治疗肝性胸水的临床疗效。方法 55例肝性胸水患者随机分成治疗组(27例)和对照组(28例),治疗组采用中心静脉导管留置胸腔持续引流胸水,胸水经B超或胸部X线片证实完全排净后注入高渗葡萄糖溶液。对照组则采用常规胸腔穿剌抽胸水治疗。两组患者均给予护肝、输白蛋白等支持治疗,观察两组患者的治疗效果和并发症的发生情况。结果 治疗组治疗总有效率为81.5%,对照组治疗总有效率为71.4%,两组比较有明显差异(P<0.05);治疗组胸水穿刺次数、胸水消退的天数、穿刺费用和住院天数较对照组均明显缩短(P<0.05),并发症少。结论中心静脉导管联合高渗葡萄糖治疗肝性胸水的疗效显著,操作简便,副作用少,值得临床推广。

Objective To observe the curative effect of central venous catheter combined with hypertonic glucose in treatment of hepatic hydrothorax. Methods Fifty-five patients with hepatic hydrothorax were randomly divided into treatment group（27 cases） and control group（28 cases）.The pleural effusion of patients in treatment group was continuous drainaged by central venous catheter.Hypertonic glucose was injected into thoracic cavity after pleural effusion excluded entirely which were confirmed by B ultrasonography or chest X-ray.The pleural effusion of patients in control group was punctured by conventional treatment.All patients were given albumin and other support treatment to protect the liver.The curative effect and complications of two groups were observed. Results The total effective rate of treatment group was 81.5%,significantly better than that of control group（71.4%）（P0.05）.Compared with control group,the puncture number of pleural effusion,days for pleural effusion persisted,cost of puncture and hospital stay days in treatment group were significantly shorter（P0.05）,with few complications. Conclusion The treatment of central venous catheter combined with hypertonic glucose has a good effect on treatment of hepatic hydrothorax.The operation is simple,and there is no adverse effection.It should be valuable to widespread popularization.