腹水超滤浓缩回输治疗肝肾综合征顽固性腹水效果观察

发布时间：2018-03-24 15:03

本文选题：肝肾综合征　切入点：顽固性腹水　出处：《山东医药》2015年44期

【摘要】：目的探讨腹水超滤浓缩回输治疗肝肾综合征顽固性腹水的疗效。方法选取肝肾综合征并发顽固性腹水患者88例,随机分为超滤组和置管组各44例。超滤组采用腹水超滤浓缩回输,置管组给予腹腔置管引流。比较两组疗效,记录两组治疗前后体质量、腹围、24 h尿量,监测两组肝肾功能、电解质及腹水总蛋白、钾、钠。结果超滤组总有效率84.09%,置管组68.18%,P0.05。两组治疗后体质量、腹围均较治疗前减少,24 h尿量升高,且超滤组上述改变较置管组更明显,P均0.05。与治疗前比较,两组治疗后血清白蛋白水平均升高,尿素氮、肌酐水平均降低,超滤组上述改变较置管组更明显,P均0.05。与治疗前比较,治疗后超滤组腹水总蛋白、钠水平升高,钾水平降低,P均0.05;置管组总蛋白水平升高,P0.05;治疗后超滤组腹水总蛋白、钠水平高于置管组,钾水平低于置管组,P均0.05。结论腹水超滤浓缩回输治疗肝肾综合征顽固性腹水效果确切,优于腹腔置管引流。
[Abstract]:Objective to investigate the efficacy of ultrafiltration and retransfusion of ascites in the treatment of refractory ascites with hepatorenal syndrome. Methods 88 patients with hepatorenal syndrome complicated with refractory ascites were selected. Each group was randomly divided into ultrafiltration group (n = 44) and catheterization group (n = 44). The ultrafiltration group was given ascites concentration and retrofusion, and the tube group was given abdominal catheterization and drainage. The curative effect was compared between the two groups. The body mass, 24 h urine volume and liver and kidney function were recorded before and after treatment in both groups, and the function of liver and kidney were monitored. Results the total effective rate of ultrafiltration group was 84.09, and that of tube insertion group was 68.18 and P0.05.The body weight and abdominal circumference of the two groups decreased 24 h urine volume increased compared with that before treatment. Compared with before treatment, the serum albumin level increased, urea nitrogen and creatinine levels decreased in the ultrafiltration group, and the above changes in the ultrafiltration group were more obvious than that in the tube insertion group (P 0.05). Compared with before treatment, the serum albumin level in the two groups was higher than that before treatment, and the levels of urea nitrogen and creatinine in the ultrafiltration group were significantly lower than those in the tube insertion group (P < 0.05). After treatment, the levels of total protein and sodium in ascites of ultrafiltration group were increased, the level of potassium was decreased (P < 0.05), the level of total protein in group A was higher than that in group A (P 0.05), and the level of sodium in ultrafiltration group was higher than that in group B (P < 0.05). The potassium level was lower than that in the catheterization group (P < 0.05). Conclusion Ultrafiltration and retransfusion of ascites is effective in the treatment of refractory ascites in patients with hepatorenal syndrome, and is better than that in peritoneal catheterization and drainage.
【作者单位】：沧州市传染病医院;
【基金】：沧州市科学技术研究与发展指导计划项目[(2009)07]
【分类号】：R575.2

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