软肝利水方联合逐水方敷脐治疗脾虚水停型肝硬化难治性腹水的临床研究

探讨分析软肝利水方联合逐水方敷脐治疗脾虚水停型肝硬化难治性腹水的临床研究。方法 开展的期限:2023.01,结束的年限:2024.01;研究诊室:奎东农场医院中医科;疾病选择种类:脾虚水停型肝硬化难治性腹水;疾病收集状况:100例患者;分组模式:双盲法机制分组;分组称呼:方剂组、参照组。方剂组在另一组的基础上增加软肝利水方治疗,参照组采取常规治疗与逐水方敷脐治疗。比较两组症状积分、肝功能情况、免疫水平、腹水情况。结果 实施之前,病人的腹水表现症状表现很明显,(P>0.05);实施之后,腹水表现症状有所缓解,方剂组的改善程度是最大的,(P<0.05)。病人的肝功能均不正常,(P>0.05);用药后,肝功能障碍有减轻,方剂组肝功能障碍程度的减轻最为理想,(P<0.05)。病人的免疫功能有所降低,(P>0.05);治疗过后,免疫功能有上升,方剂组的免疫功能最好,(P<0.05)。病人的腹水体征很严重,(P>0.05);在用药后的腹水体征有所减轻,方剂组的腹水体征最佳,(P<0.05)。结论 软肝利水方联合逐水方敷脐治疗脾虚水停型肝硬化难治性腹水的临床疗效十分显著,表现症状有一定减轻,病情的严重程度得到改善,该治疗方案建议在临床上广泛应用。

加味葶苈大枣汤治疗血瘀水停型肝硬化腹水40例临床观察

目的:观察加味葶苈大枣汤治疗肝硬化腹水的临床疗效。方法:对80例肝硬化腹水患者采取随机分组对照治疗方法,治疗组采用西医基础治疗联合加味葶苈大枣汤,对照组仅予西医基础治疗。疗程为12周,观察两组治疗前后临床症状积分、腹围、肝功能、凝血功能、腹水量、Child-Pugh评分。结果:两组治疗后症状均明显缓解、肝功能及凝血功能指标、腹水量、Child-Pugh评分改善(P<0.05),治疗组在改善患者乏力、腹胀、纳差、Child-Pugh评分等方面明显好于对照组(P<0.05)。结论:加味葶苈大枣汤联合西药治疗具有较好的消退肝硬化腹水作用。

肝硬化肝性胸水临床诊治分析

目的：探讨肝硬化肝性胸水的临床诊治效果。方法：选取我院2009年1月～2012年12月240例肝硬化肝性胸水患者，将其分为研究组和对照组，对照组予以常规治疗，研究组实施中西医结合，分析对比2组患者治疗效果及安全性。结果：研究组患者经过治疗后总有效率达到95％，而对照组为85％，存在明显统计学差异（P〈0．05），研究组并发症明显降低。结论：中西医结合治疗肝硬化肝性胸水症状具有较高有效性，且其安全性高，可以进行广泛临床推广。

肝硬化肝性胸水临床诊治分析

目的探讨分析肝硬化肝性胸水患者的临床诊断措施以及治疗效果。方法 96例肝硬化肝性胸水患者,随机分为对照组和观察组,各48例。对照组给予水电解质平衡、利尿等常规西医治疗,观察组在对照组的基础上添加四妙回春汤治疗,对比两组患者治疗效果以及不良反应发生率。结果观察组患者治疗有效率(93.8%)高于对照组患者(79.2%),差异有统计学意义(P<0.05)。两组患者治疗期间均未见明显不良反应。结论给予肝硬化肝性胸水患者全面诊断能有助于医生了解患者诸多病情信息,而中西医联合应用则能显著提高患者治疗效果,值得临床推广。

养肝汤治疗肝硬化胸腹水40例

目的:观察养肝汤治疗肝硬化胸腹水的临床疗效。方法:将80例患者随机分为治疗组和对照组各40例。治疗组口服养肝汤治疗,对照组给予西药常规处理。结果:总有效率治疗组85%,对照组为52.5%,两组比较差异有非常显著性意义(P<0.01)。结论:养肝汤治疗肝硬化胸腹水疗效较好,且远期疗效尚可,复发率较低。

肝硬化肝性胸水的临床诊治体会

目的研究并分析肝硬化肝性胸水的临床诊断与治疗方法。方法我院2011年11月1日至2013年1月1日期间共收治肝硬化肝性胸水患者120例,将上述120例患者进行随机分组,即对照组的60例患者运用常规治疗方式进行治疗,观察组的60例患者运用中西医结合的方式进行治疗,对比上述两组患者的临床治疗安全性与有效性。结果观察组患者的临床治疗总有效率为95%,与对照组患者的85%相比,差异具有显著性,即P<0.05。结论对于肝硬化肝性胸水患者而言,运用中西医结合的方式进行治疗十分安全,疗效显著性,值得推广。

肝硬化肝性胸水临床诊治分析

目的探讨肝硬化肝性胸水患者的临床诊治。方法 60例肝硬化肝性胸水患者,随机分为观察组与对照组,各30例。对照组给予常规治疗,观察组给予中西医结合治疗。对比两组患者的临床治疗效果和术后并发症发生率。结果观察组治疗总有效率明显高于对照组(P<0.05),并发症发生率明显低于对照组,差异具有统计学意义(P<0.05)。结论肝硬化肝性胸水患者的临床诊治过程中,给予中西医结合治疗,具有较高的安全性和有效性,可有效提高患者治疗有效率,降低并发症发生率,具有重要的作用。

肝硬化肝性胸水临床护理体会

目的对肝硬化肝性胸水的护理方法及效果进行观察分析。方法根据随机双盲法将本院收治的92例肝硬化肝性胸水患者分为观察组与参考组,各为46例,观察组患者在常规护理基础上接受优质护理干预,参考组患者接受常规临床护理,比较两组患者治疗总有效率及并发症发生率。结果观察组患者治疗总有效率为93.5%,参考组患者治疗总有效率为78.3%,比较差异有统计学意义(P<0.05),观察组患者感染并发症发生率明显少于参考组,比较差异有统计学意义(P<0.05)。结论在肝硬化肝性胸水治疗期间给予优质护理有助于提高治疗效果,减少并发症发生情况。

针药并用治疗肝硬化胸水18例

<正> 肝硬化胸水,为肝硬化患者常见的并发症之一。虽然它比肝硬化腹水相对较少,但是一旦出现,比腹水患者更为凶险。我们在临床上运用梅花针疗法和自拟中药“芪桑葶蒌汤”并施,治疗肝硬化胸水18例,取得了良好的临床疗效,现总结如下: 一、临床资料 本组病人均经临床体检、化验及B超。

自拟消胀利水方治疗乙肝肝硬化腹水的疗效及低钠血症发生率分析

目的观察自拟消胀利水方治疗乙肝肝硬化腹水的疗效和发生低钠血症情况。方法观察病例共60例,随机分为治疗组和对照组各30例。在基础治疗的基础上,治疗组用自拟消胀利水方治疗,对照组用安体舒通合速尿针治疗,1个月后观察电解质(钾、钠)、肝功能、血常规变化情况。结果2组血常规、肝功能治疗前后比较有明显差异(P<0.01),对照组血钾、血钠治疗前后有明显差异(P<0.01),治疗组治疗前后无明显差异(P>0.05)。结论2组治疗前后肝功能、血常规均不同程度的改善,治疗后对照组血钾、血钠下降明显,而治疗组血钾、血钠前后保持稳定,2组比较差异非常显著(P<0.01),说明自拟消胀利水方能促进肝细胞恢复,降低电解质紊乱发生率。

渣油型合成氨气化工段碳黑水净化的改造设想

渣油型化肥厂合成氨气化工段的气化炉后加置旋液分离器 ,改造气化炉结构 ,使灰渣不滞留于气化炉中 ,随激冷水流到旋液分离器中 ,将激冷水中全部能堵塞后序流程设备的灰渣沉淀 ,定期排放到屯渣槽中 ,干净的不含有堵塞设备的灰渣的碳黑水送往碳黑回收工段。改造实施后可解决后序设备堵塞现象和气化炉定期清渣的瓶颈问题及碳黑回收系统普遍出现的温度偏高。

特利加压素治疗肝性胸水的体会(附2例报告)

目的:探讨肝硬化肝性胸水的临床诊治。方法:2例肝硬化失代偿期顽固性腹水并肝性胸水患者,经限制钠盐的摄入、利尿、补充白蛋白、营养支持、保肝及腹腔穿刺抽液等综合治疗1周以上临床无效,在此基础上加用特利加压素(例1胸腹水合并肝肾综合征,特利加压素按照1 mg q6h持续泵入3天,血清肌酐水平下降15.68%未达标,第4天剂量加倍2 mg q6h持续泵入治疗4天停药;例2顽固性腹水并胸水,特利加压素2 mg q12h静点治疗7天停药)治疗7天,治疗后观察临床症状、胸腹水及尿量变化情况。结果:根据治疗前后超声及胸片观察胸水及腹水的变化,评估疗效。2例患者均经基础治疗1周无效后加用特利加压素治疗1周,肾功、尿量、腹水及胸水均得到有效改善及控制,短期内无反复,前后对比疗效有显著差异。结论:临床观察结果表明,特利加压素对肝硬化肝性胸水有一定临床疗效,有进一步研究的价值。

Kinetics of AlOOH dissolving in caustic solution studied by high-pressure DSC

Mechanism functions and kinetic parameters of AlOOH（boehmite or diaspore） dissolving in sodium hydroxide solution were researched.The mixture of boehmite or diaspore and caustic solution was scanned by high-pressure differential scanning calorimetry（DSC） instrument with heating rate of 10 ℃/min,and differential equation method was used to analyse the DSC curves,combining with iterative method and linear least square method.The most probable mechanism functions for both boehmite or diaspore and caustic solution reactions were logically selected from 30 types of non-isothermal kinetics differential equations,according to the calculated results obtained by Matlab program.The most probable differential mechanism function of boehmite dissolving in caustic solution is f（α）=1-α,which reveals the first-order reaction with apparent activation energy of 79.178 kJ/mol and the preexponential constant 1.031×108 s-1.The function,f（α）=2（1-α）3/2,can describe the dissolution of diaspore sample in sodium hydroxide solution.The calculated results of kinetic parameters are apparent activation energy of 73.858 kJ/mol,preexponential constant of 5.752×107 s-1 and reaction order of 1.5.

A case of successful management with splenectomy of intractable ascites due to congenital dyserythropoietic anemia type II-induced cirrhosis

The congenital dyserythropoietic anemias comprise a group of rare hereditary disorders of erythropoiesis, characterized by ineffective erythropoiesis as the predominant mechanism of anemia and by characteristic morphological aberrations of the majority of erythroblasts in the bone marrow. Congenital dyserythropoietic anemia type II is the most frequent type. All types of congenital dyserythropoietic anemias distinctly share a high incidence of iron loading. Iron accumulation occurs even in untransfused patients and can result in heart failure and liver cirrhosis. We have reported about a patient who presented with liver cirrhosis and intractable ascites caused by congenital dyserythropoietic anemia type II. Her clinical course was further complicated by the development of autoimmune hemolytic anemia. Splenectomy was eventually performed which achieved complete resolution of ascites, increase of hemoglobin concentration and abrogation of transfusion requirements.

Hydration phase and pore structure evolution of hardened cement paste at elevated temperature

To understand the effect of steam curing temperature on the hydrate and microstructure of hardened cement paste,several measuring methods including X-ray diffraction(XRD),atomic absorption spectroscopy(ASS),ion chromatography,conductivity meter,alternating-current impedance spectroscopy and nuclear magnetic resonance(NMR)are employed to investigate the hydration characteristics,pore solution composition and conductivity,resistivity and pore structure during the steam curing process.Experimental results show that steam curing promotes the hydration process,greatly raises the resistivity,and decreases the porosity of specimen at early age.Compared with being treated at 45℃,higher temperature leads to a fast decomposition of ettringite at initial stage of the constant temperature treatment period,which improves the relative content and ionic activity of the conductive ions in pore solution.Furthermore,the number of pores larger than 200 nm increases significantly,which reduces the resistivity of the hardened cement paste.Cement paste treated at 45℃ has a more stable and denser microstructure with less damages.

High circulating D-dimers are associated with ascites and hepatocellular carcinoma in liver cirrhosis

AIM: To measure plasma D-dimer levels in cirrhotic patients with and without ascites, assessing the effect of ascites resolution in D-dimer concentration. METHODS: Seventy consecutive cirrhotic patients (M = 44, F = 26, mean age 65 years, SD ± 13), observed from October 2005 to March 2006 were enrolled. Circulating D-dimer levels were measured using a latex-enhanced, immunoturbidimetric test. In patients with ascites (n = 42) the test was repeated after ascites resolution. RESULTS: Ascites was present in 42 patients (group A) and absent in 28 (group B). Group A patients had more advanced liver disease. Hepatocellular carcinoma (HCC) was diagnosed in 14 patients and was more frequent in group B. Above normal range D-dimers were found in 45/70 patients. High D-dimers were more frequent in group A than in group B (P = 0.001). High D-dimers were associated with presence of HCC (P = 0.048) only in group B. After ascites resolution, obtained in all patients, mean D-dimer values decreased in those 34 patients with high basal levels (P = 0.007), returning to normal in 17. CONCLUSION: In patients with liver cirrhosis, ascites and HCC are the main factors associated with increased fibrinolytic activity.

Increased intestinal macromolecular permeability and urine nitrite excretion associated with liver cirrhosis with ascites

AIM： To determine intestinal permeability, the serum tumor necrosis factor （TNF）-α level and urine nitric oxide （NO） metabolites are altered in liver cirrhosis （LC） with or without ascites. METHODS： Fifty-three patients with LC and 26 healthy control subjects were enrolled in the study. The intestinal permeability value is expressed as the percentage of polyethylene glycol （PEG） 400 and 3350 retrieval in 8-h urine samples as determined by high performance liquid chromatography. Serum TNF-α concentrations and urine NO metabolites were determined using an enzyme-linked immunosorbent assay （ELISA） and Greiss reaction method, respectively. RESULTS： The intestinal permeability index wassignificantly higher in patients with LC with ascites than in healthy control subjects or patients with LC without ascites （0.88 ± 0.12 vs 0.52 ± 0.05 or 0.53 ± 0.03, P 〈 0.05） and correlated with urine nitrite excretion （r = 0.98）. Interestingly, the serum TNF-α concentration was significantly higher in LC without ascites than in control subjects or in LC with ascites （198.9 ± 55.8 pg/mL vs 40.9 ± 12.3 pg/mL or 32.1 ± 13.3 pg/mL, P 〈 0.05）. Urine nitrite excretion was significantly higher in LC with ascites than in the control subjects or in LC without ascites（ 1170.9± 28.7 μmol/L vs 903.1 ± 55.1 μmol/L or 956.7 ± 47.7 μmol/L, P 〈 0.05）. COMCLUSIOM： Increased intestinal macromolecular permeability and NO is probably of importance in the pathophysiology and progression of LC with ascites, but the serum TNF-α concentration was not related to LC with ascites.

Leptin levels in the differential diagnosis between benign and malignant ascites

AIM： To evaluate the role of leptin levels in the differentia diagnosis of ascites. METHODS： Ascitic leptin, TNFα and serum leptin levels were measured in 77 patients with ascites （35 with malignancies, 30 cirrhosis and 12 tuberculosis）. Control serum samples were obtained from 20 healthy subjects. Leptin and TNFα levels were measured by EUSA. Body mass index （BMI） and percentage of body fat （BFM） by skin fold measurement were calculated for all patients and control groups. Peritoneal biopsy, ascites cytology and cultures or biochemical values were used for the diagnosis of patients. RESULTS： In patients with malignancies, the mean serum and ascites leptin levels and their ratios were significantly decreased compared to the other patient groups and controls. In tuberculosis peritonitis, ascitic fluid TNFα levels were significantly higher than malignant ascites and cirrhotic sterile ascites. BMI and BFM values did not distinguish between patients and controls. CONCLUSION： In patients with malignant ascites, levels of leptin and TNFα were significantly lower than in patients with tuberculous ascites.