摘要
目的观察自体腹水浓缩回输治疗肝硬化顽固性腹水患者的肾素-血管紧张素-醛固酮(RAAS)激素水平变化及临床疗效。方法回顾性分析2013年1月至2018年6月遵义医学院附属医院收治的105例肝硬化顽固性腹水的临床资料,按治疗方法分为观察组60例和对照组45例,观察组患者采用自体腹水浓缩回输治疗,对照组采用常规腹腔穿刺抽液、补充白蛋白治疗。观察两组患者治疗前1 d及治疗后3 d的RAAS变化及临床疗效。结果治疗前1 d两组患者的肾素、血管紧张素Ⅱ、醛固酮水平以及体质量、腹围比较差异均无统计学意义(P>0.05);治疗后3 d,两组患者的体重、腹围均减少,观察组患者的24 h尿量为(1 547±397.5) mL,明显多于对照组的(1 068.2±320.4) mL,肾素、血管紧张素Ⅱ、醛固酮分别为(2.32±0.43) ng/(mL·h)、(265.82±86.65) ng/mL、(154.23±37.52) ng/mL,均明显低于对照组的(3.52±0.75) ng/(mL·h)、(323.2±99.62) ng/mL、(368.2±96.42) ng/mL,差异均有统计学意义(P<0.05);观察组治疗后的临床总有效率为90.0%,明显优于对照组的48.9%,差异有统计学意义(P<0.05)。结论自体腹水浓缩回输治疗肝硬化顽固性腹水可降低RAAS系统激素水平,改善患者症状,是一种安全、有效的治疗方法。
Objective To observe the changes of renin-angiotensin-aldosterone(RAAS) hormone levels in patients with refractory ascites due to cirrhosis and its clinical efficacy. Methods A retrospective analysis was made on105 cases of refractory ascites due to cirrhosis admitted to the Affiliated Hospital of Zunyi Medical College from January 2013 to June 2018. According to the treatment method, the patients were divided into the observation group(60 cases) and the control group(45 cases). The patients in the observation group were treated with concentrated reinfusion of autologous ascites, while the patients in the control group were treated with routine abdominal puncture and aspiration and albumin supplementation. The changes of RAAS and its clinical efficacy were observed 1 day before treatment and3 days after treatment in both groups. Results There was no significant difference in renin, angiotensin Ⅱ, aldosterone levels, body weight and abdominal circumference between the two groups one day before treatment(P>0.05). Three days after treatment, the body weight and abdominal circumference of the patients in the two groups decreased. The24-hour urine volume of the patients in the observation group was(1 547±397.5) mL, which was significantly higher than(1 068.2 ± 320.4) mL in the control group. The renin, angiotensin Ⅱ and aldosterone in the observation group were(2.32 ± 0.43) ng/(mL·h),(265.82 ± 86.65) ng/mL,(154.23 ± 37.52) ng/mL, respectively, significantly lower than(3.52±0.75) ng/(mL·h),(323.2±99.62) ng/m L and(368.2±96.42) ng/m L in the control group(P<0.05). The clinical total effective rate of the observation group was 90.0% after treatment, which was significantly better than 48.9% in the control group(P<0.05). Conclusion Autogenous ascites reinfusion is a safe and effective treatment for refractory ascites due to cirrhosis, which can reduce the hormone level of RAAS system and improve the symptoms of patients.
作者
赵开飞
谭瑞
石荣书
ZHAO Kai-fei;TAN Rui;SHI Rong-shu(Interventional Department,the Affiliated Hospital of Zunyi Medical College,Zunyi 563000,Guizhou,CHINA)
出处
《海南医学》
CAS
2019年第3期281-283,共3页
Hainan Medical Journal
基金
贵州省科技厅项目(编号:黔科合NY字[2006]3056号
黔科合LH字[2017]7110号)
关键词
肝硬化
顽固性腹水
浓缩回输
白蛋白
疗效
Liver cirrhosis
Refractory ascites
Reinfusion
Albumin
Curative effect
