特利加压素联合腹水回输治疗肝肾综合征的疗效分析

The Analysis of the Clinical Curative of Trey Vasopressin Combined with Ultrafiltration Reinfusion of Concentrated Ascites in Treatment of Hepatorenal Syndrome

目的:探讨特利加压素联合腹水超滤浓缩回输治疗肝硬化顽固性腹水伴Ⅱ型肝肾综合征的临床疗效。方法:收集我院感染科2010年10月—2016年10月确诊的肝硬化顽固性腹水伴Ⅱ型肝肾综合征的患者180例,根据治疗方法分为观察组与对照组,每组90例。观察组:腹水超滤浓缩回输术治疗,术后白蛋白静脉滴注,同时静脉滴注特利加压素,疗程为7d;对照组:反复抽放腹水,术后白蛋白静脉滴注。对比两组患者腹水、尿量、肝肾综合征相关疗效、治疗有效率等指标。结果:两组患者治疗后腹围、体重、24h尿量、血清—腹水白蛋白浓度梯度(SAAG)、血Na+、BUN(尿素氮)、CREA(肌酐)水平均较治疗前明显改善(P<0.05),观察组患者各指标改善情况明显优于对照组(P<0.05)。结论:特利加压素联合腹水超滤浓缩回输治疗肝肾综合征,可显著改善腹水症状,改善肾功能,降低SAAG,减少肝硬化并发症发生,改善肝硬化预后。

Objective： To study the clinical curativ of trey vasopressin combined with ultrafiltration reinfusion of concentrated ascites in treatment of liver cirrhosis with type Ⅱhepatorenal syndrome. Methods： 180 cases of liver cirrhosis with typeⅡhepatorenal syndrome treated Xiamen Haicang hospital from October 2010 to October 2016 were randomly divided into study group and control group,90 cases in each group. Study group patients were treated with reinfusion of ascites concentration by ultrafiltration back to abdominal cavity,then supplementation of albumin,the same time given trey vasopressin,and the course of treatment was 7 days. Control group patients were treated with peritoneal effusion. Compared two groups of patients with ascites,urination,hepatorenal syndrome related efficacy indicators and efficiency. Results： Abdominal circumference,weight,24 hours urine volume,Serum-Ascites Albumin Gradient,serum sodium,potassium,urea nitrogen and creatinine were significantly improved in the two groups after treatment（ P〈0. 05）,the improvement of each index in study group were significantly better than control group（ P〈0. 05）. Conclusion： Trey Vasopressin combined with ultrafiltration reinfusion of concentrated ascites in liver cirrhosis with type Ⅱ hepatorenal syndrome,can significantly relieved the symptoms of ascites,improved renal function,reduced SAAG and the incidence of complications of cirrhosis,imp,improved the prognosis of liver cirrhosis.