特利加压素联合腹水浓缩回输术治疗肝硬化并发顽固性腹水患者临床研究

Clinical observation of terlipressin combined with ascites concentration and reinfusion in the treatment of patients with refractory ascites

目的探讨应用特利加压素联合腹水浓缩回输术治疗肝硬化并发难治性腹水患者的临床效果。方法2017年5月~2019年10月解放军联勤保障部队第901医院感染病科诊治的肝硬化并发顽固性腹水患者54例,采用随机数字表法将患者分为观察组(n=27)和对照组(n=27)。对照组患者接受腹水浓缩回输术治疗,观察组在对照组治疗的基础上联合应用特利加压素治疗1周,观察两组肝肾功能、体质量、腹围、腹水和尿量的变化。结果在观察结束时,观察组和对照组腹围分别为(86.3±4.3)cm和(89.8±6.4)cm(P<0.05),腹水深度分别为(31.5±8.4)mm和(53.3±9.4)mm(P<0.05),血清胆红素水分别为(60.8±9.8)μmol/L和(71.5±8.7)μmol/L(P<0.05),白蛋白水平分别为(33.3±3.0)g/L和(30.0±3.1)g/L(P<0.05),尿素氮分别为(6.8±1.8)μmol/L和(9.8±2.8)μmol/L(P<0.05),血清肌酐分别为(104.5±14.4)μmol/L和(133.8±15.3)μmol/L(P<0.05),24 h尿量分别为(1088.3±285.9)mL和(1385.9±337.9)mL(P<0.05),差异显著;观察组和对照组住院日分别为(28.8±3.7)d和(38.5±8.3)d(P<0.05);腹水浓缩分别进行了(4.3±1.4)次和(10.7±3.2)次(P<0.05),差异显著。结论应用特利加压素联合腹水浓缩回输术治疗肝硬化并发顽固性腹水患者能减少腹水量、改善肝肾功能、缩短住院日,值得进一步验证。

Objective To analyze the clinical effect of terlipressin combined with ascites concentration and reinfusion on refractory ascites patients with cirrhosis.Methods 54 cirrhotic patients with obstinate ascites were divided into observation group(n=27)and control group(n=27)from May 2017 to October 2019.The control group was treated with ascites concentration and reinfusion,and the observation group was treated with terlipressin on the basis of the control group.Results At the end of 14 day observation,the abdominal circumferences of patients in observation and control groups were(86.3±4.3)cm and(89.8±6.4)cm,the depth of ascites were(31.5±8.4)mm and(53.3±9.4)mm,serum bilirubin levels were(60.8±9.8)μmol/L and(71.5±8.7)μmol/L,serum albumin levels were(33.3±3.0)g/L and(30.0±3.1)g/L,serum BUN were(6.8±1.8)μmol/L and(9.8±2.8)μmol/L,sCr were(104.5±14.4)μmol/L and(133.8±15.3)μmol/L,significantly different between the two groups(P<0.05),and the 24 h urine volume were(1088.3±285.9)mL and(1385.9±337.9)mL,the hospital stays were(28.8±3.7)d and(38.5±8.3)d,and the ascites concentration and reinfusion were(4.3±1.4)times and(10.7±3.2)times,respectively,significantly different between the two groups(P<0.05).Conclusion The application of terlipressin combined with ascites concentration and reinfusion could reduce the amount of ascites,improve the functions of liver and kidney,shorten the length of hospital stay,and needs further investigation.