腹水超滤浓缩回输腹腔术治疗肝硬化顽固性腹水疗效分析

摘要

目的 探讨腹水超滤浓缩回输腹腔术治疗肝硬化顽固性腹水的疗效.方法 将56 例肝硬化顽固性腹水患者随机分为2 组,均给予保肝、利尿及抗病毒治疗.在此基础上,对治疗组行腹水超滤浓缩回输腹腔术加小剂量人血白蛋白静脉滴注(静滴)(每滤出1000 ml 腹水,静滴人血白蛋白4 g),对对照组行大量放腹水加大剂量人血白蛋白静滴(每抽出1000 ml 腹水,静滴人血白蛋白8 g).结果 术后第14 天,治疗组患者24 h 尿量、血清ALB 水平均高于对照组(P 均＜0.05),且治疗组总有效率高于对照组(P＜0.05).结论 腹水超滤浓缩回输腹腔术是一种安全有效的治疗肝硬化顽固性腹水的方法.%Objective To investigate the efficacy of ascitic ultrafiltratioii with iniraperitoneal reinfusion of the concentrated ascites or. refractory ascites in patients with liver cirrhosis. Methods Totally 56 cirrhotic patients with refractory ascites were randomized into a treatment group and a control group. The patients in the two groups received conventional therapy including hepato-protective, diuretic and antiviral therapy. In addition, the treatment group underwent ascitic ultrafiltration with intraperitoneal reinfu-sion of the concentrated ascites and intravenous infusion of a small dose of human scrum ALB (4 g for every 1000 ml of ascitic fluid removed), while Lite control group received large volume paracenlesis and intravenous infusion of a large dose of human serum ALB (8 g for eveny 1000 ml of ascitic fluid removed). Results After 14 days of treatment, the 24-hour urine volume and serum ALB level in the treatment group were higher than those in the control group (P<0.05). The total effective rate in the treatment group was higher than that in the control group (P<0.05). Conclusion Ascitic ultrafiltratioii with mtraperitoneal reinfusion of the concentrated as-cites is safe and effective in the treatment of refractor}' ascites in cirrhotic patients.