自身腹水浓缩回输治疗难治性腹水的回顾性分析

A Retrospective Control Analysis of Reinfusion of Concentrated Self-ascites on Treating Refractory Ascites

目的 :评价自身腹水浓缩回输术对缩短患者住院时间、节约白蛋白与相关药物用量、降低并发症发生率及病情转归的影响。方法 :以复旦大学附属中山医院 1997年～ 2 0 0 1年的肝硬化腹水浓缩回输病例 31例为研究组 ,以同期传统方法治疗的肝硬化难治性腹水 31例为对照组 ,对两组病例的相关数据进行对照分析。结果 :研究组回输前血浆白蛋白 2 8.73± 3.97g /L ,回输后为 30 .73± 5 .16 g /L(P <0 .0 5 ) ,两组住院天数分别为 38.97± 30 .81d和 37.74± 17.93d(P >0 .0 5 ) ,住院期间白蛋白用量两组分别为 1.0 6 5± 0 .85 1g /d和 1.4 5 1± 1.4 5 3g /d(P >0 .0 5 ) ,血制品用量分别为 11.4 4± 2 1.38ml /d和 14 .0 8± 2 4 .0 4ml /d(P >0 .0 5 ) ,口服呋塞米用量分别为 2 8.5 5± 2 3.4 4mg /d和 2 9.83± 2 8.2 9mg /d(P >0 .0 5 ) ,注射呋塞米用量分别为13.5 6± 16 .0 9mg /d和 17.5 6± 34.0 2mg /d ,螺内酯用量分别为 99.87± 5 3.4 4mg /d和 76 .4 2± 5 1.6 1mg /d(P >0 .0 5 )。结论 :自身腹水浓缩回输术可显著提高患者的血浆白蛋白 ,且不会增加肝硬化并发症的发生率 ,但是与传统方法比较并不能缩短患者住院时间 。

Objective: This study is to evaluate whether the technique of reinfusion of concentrated self-ascites(RCSA)could shorten the in-patient admission days or reduce the usage of albumin and relative drugs. The effects on complications and development of disease had also been evaluated. Methods: A retrospective control study had been conducted in Zhongshan Hospital, Fudan University, to review 31 refractory cirrhotic ascites patients admitted from 1997 to 2001 who had received reinfusion of concentrated self-ascites(RCSA) and another 31 refractory cirrhotic ascites patients who were admitted at the same time received routine therapy as control. Results:In study group, plasma albumin level were 28.73±3.97g /L and 30.73± 5.16g /L respectively before and after treatment(P<0.05). The in-patient admission days were 38.97±30.81d for study group and 37.74±17.93d for control group. During admission time, the dosage of albumin infusion were 1.065±0.851g /d and 1.451±1.453g /d (P>0.05), blood infusion were 11.44±21.38ml /d and 14.08±24.04ml /d(P>0.05), oral fusemide were 28.55±23.44mg /d and 29.83±28.29mg /d(P>0.05), infused fusemide were 99.87±53.44mg /d and 76.42±51.61mg /d(P>0.05), antisterone were 99.87±53.44mg /d and 76.42±51.61mg /d(P>0.05), respectively in two groups. Conclusion:RCSA could significantly increase plasma albumin and not increase the incidence of cirrhotic complications. However, compared with control group, RCSA could not shorten the in-patient admission days or reduce the usage of albumin or relative drugs.