腹水浓缩回输治疗肝硬化顽固性腹水研究.docVIP

腹水浓缩回输治疗肝硬化顽固性腹水研究 　　[摘要] 目的 评价腹水浓缩回输治疗肝硬化所致顽固性腹水的疗效。 方法 选择肝硬化所致顽固性腹水患者50例，随机分为两组：观察组28例，进行腹水浓缩回输治疗；对照组22例，采用大量放腹水加输注白蛋白治疗。结果 两组患者的腹水量均明显减少，疗效相同，差异无统计学意义（P0.05）；观察组腹腔穿刺次数少于对照组，腹水停止复发所需治疗时间短于对照组，差异有统计学意义（P0.05）。 结论 腹水浓缩回输是治疗肝硬化所致顽固性腹水的一种有效措施，短期治疗效果优于大量放腹水加输注白蛋白，患者痛苦小，花费少，两种方法长期疗效相同。 　　[关键词] 腹水浓缩回输；肝硬化；顽固性腹水 　　[中图分类号] R575.2 [文献标识码] B [文章编号] 1673-9701（2014）23-0106-03 　　[Abstract] Objective To evaluate the curative efficacy of concentrated ascites reinfusion in the treatment of refractory cirrhotic ascites. Methods Fifty patients with cirrhosis and refractory ascites were randomly divided into two groups.28 patients in observation group were treated with ascitic concentration and reinfusion device. 22 patients in control group were treated with abdominol paracentesis apocenosis and infusion albumin. Results After treatment， the ascites of patients in two groups obviously decreased. The curative effect of two groups was similar. There was no statistically significant difference（P0.05）； The frequency of abdominal paracentesis in observation group were less than that in control group，the time of ascites stop recurrence in observation group were shorter than that in control group，the difference was statistically significant（P0.05）. Conclusion The concentrated ascites reinfusion is a effectly curat in the treatment of refractory cirrhotic ascites. The recent curative effect is better than abdominol paracentesis apocenosis and infusion albumin. The suffering and spending of patients is small. The extended curative effect of two methods is similar. 　　[Key words] Concentrated ascites reinfusion； Cirrhosis； Refractory ascites 　　顽固性腹水是肝硬化失代偿期的一种严重并发症，主要表现为尿少、大量腹水不易消退，患者有较重的腹胀感，影响进食，并且易合并心肺压迫、腹膜炎、消化道出血等，生存质量差，甚至危及生命。根据国际腹水协会定义，顽固性腹水为药物治疗后腹水消退不满意或经排放腹水等治疗后药物不能防止近期复发的腹水[1]。采用利尿药物治疗不能使病情好转。很多医务工作者采取腹腔穿刺放腹水、同时静脉输注白蛋白的方式，治疗效果尚可[2]。但是因腹水中存在白蛋白，在排放腹水时，白蛋白也会随之丢失，造成血白蛋白水平进一步降低；而且由于白蛋白为生物制品，资源有限，许多患者承受不起其价格，造成治疗困难。腹水浓缩回输是将腹水从腹腔引出，通过回输仪，将多余水分滤掉，腹水中的白蛋白重新回输到腹腔中，这样即可消除腹腔内多余的水分，改善患者胸闷、腹