可调钠血液透析联合人血清蛋白静滴治疗尿毒症并大量腹水价值探讨

Clinical value discussion of sodium profile hemodialysis combined with human serum albumin infusion in the treatment of uremia with massive ascites

目的:探讨可调钠血液透析联合人血清蛋白静滴治疗尿毒症合并大量腹水的价值。方法:根据治疗方案,将65例患者分为观察组30例和对照组35例。对照组采用可调钠血液透析治疗,观察组采用可调钠血液透析联合人血清蛋白治疗。记录两组患者腹水减少50%的时间、完全消失时间、6个月后和12个月后腹水复发情况,比较两组患者肾功能、血生物化学指标。结果:观察组患者腹水减少50%时间和完全消失时间分别为(11.3±1.6)d、(16.8±3.2)d,短于对照组(P<0.05)。观察组患者半年复发5例(16.67%)、1年复发7例(23.33%),低于对照组(P<0.05)。观察组治疗后的甲状旁腺激素(intact parathyroid hormone,i PTH)与对照组比较差异有统计学意义(P<0.05)。结论:可调钠血液透析联合人血清蛋白静滴治疗尿毒症合并大量腹水具有较重要的临床价值。

Objective：To evaluate the value of sodium profile hemodialysis combined with human serum albumin infusion in the treatment of uremia with massive ascites. Methods： According to the treatment methods, 65 cases of patients with uremia and massive ascites were divided into observation group （30 cases） and control group （35 cases）. The patients in the control group received the sodium profile hemodialysis treatment while the patients in the observation group were treated with sodium profile hemodialysis combined with human serum albumin. The 50 % ascites reduction time, complete disappearing time and the recurrence rates of ascites in the 6th months and the 12th months after treatment between the two groups were recorded to compare the indicator of renal function and blood biochemistry. Results： The 50% ascites reduction time and complete disappearing time in the observation group were （11.3± 1.6 ） d and （16.8 ± 3.2 ） d respectively, which were significantly shorter than those in the control group （ P 〈 0.05 ）. In the 6th months and the 12th months after treatment, the recurrence rates of ascites in the observation group were 5 cases （16.67 % ） and 7 cases （23.33%）, which were significantly lower than those in the control group （ P 〈 0.05 ）. The intact parathyroid hormone （iPTH） level after treatment in the observation group reduced significantly compared with that in the control group （ P 〈0.05 ）. Conclusion ： Sodium profile hemodialysis combined with human serum albumin infusion has important clinical value in the treatment of uremia with massive aseites.