特利加压素联合人血白蛋白治疗肝硬化顽固性腹水的临床疗效

摘要

Objective To investigate the clinical efficacy of terlipressin combined with human albumin for refractory ascites due to cirrhosis.Methods A total of 282 patients with refractory ascites due to cirrhosis were randomly divided into control group and observation group,with 141 cases in each group. The control group was treated with human albumin on the basis of conventional treatment,the observation group was treated with terlipressin combined with human albumin on the basis of conventional treatment,and the treatment lasted for 14 days in both groups.The fasting body weight,abdominal circumference,ascites depth,24 h urine volume,diameter of portal system,serum albumin,creatinine and prothrombin time(PT) before and after treatment were compared,and clinical efficacy and incidence of complications were compared between the two groups.Results The body weight,abdominal circumference and ascites depth were lower while the 24 h urine volume was higher in the two groups after treatment in contrast with those before treatment,and the improvement in the observation group was more obvious than that in the control group(all P<0.05).The diameters of portal vein and splenic vein decreased in the two groups after treatment in contrast with those before treatment,and the diameters in the observation group was shorter than that in the control group (P<0.05).The levels of serum ALB increased while the levels of creatinine and PT decreased in both groups after treatment in contrast with those before treatment,and the improvement in the observation group was more obvious than that in the control group(all P<0.05). The total effective rate in the control group was lower than that in the observation group(P<0.05).No severe adverse reactions were found in the two groups during treatment.Conclusion Terlipressin combined with human albumin has a definite efficacy for refractory ascites due to cirrhosis,which can effectively improve the clinical and biochemical indicators and reduce the diameter of portal system.%目的 探讨特利加压素联合人血白蛋白治疗肝硬化顽固性腹水的临床疗效.方法 将282例肝硬化顽固性腹水患者随机分为观察组及对照组,每组141例,对照组在常规治疗基础上采用人血白蛋白治疗,观察组在常规治疗基础上采用特利加压素联合人血白蛋白治疗,两组均治疗14 d.观察治疗前后患者空腹体质量、腹围、腹水深度、24 h尿量、门脉系统内径、血清ALB、肌酐及凝血酶原时间(PT)等指标的变化情况,比较两组患者的临床疗效及不良反应发生情况.结果 治疗后两组患者体质量、腹围、腹水深度均低于治疗前,24 h 尿量均高于治疗前,且观察组改善较对照组明显(均P<0.05).治疗后两组门静脉内径、脾静脉内径均较治疗前缩短,且观察组均短于对照组(P<0.05).治疗后两组血清ALB水平均较治疗前升高,肌酐、PT均较治疗前降低,且观察组改善较对照组明显(均P<0.05).对照组总有效率低于观察组(P<0.05).两组患者治疗期间均未发生严重不良反应.结论 特利加压素联合人血白蛋白治疗肝硬化顽固性腹水的疗效确切,可以有效改善患者各项临床及生化指标,并减小门脉系统内径.