中心静脉导管腹腔引流治疗顽固性腹水36例分析

郭海军; 佟雪飞

doi:10.3969/j.issn.1001-5256.2013.10.015

中心静脉导管腹腔引流治疗顽固性腹水36例分析

DOI: 10.3969/j.issn.1001-5256.2013.10.015

邢台市人民医院肝病科

详细信息

中图分类号: R575.2
计量
- 文章访问数: 2796
- HTML全文浏览量: 16
- PDF下载量: 587
- 被引次数: 0
出版历程
- 收稿日期: 2013-01-23
- 出版日期: 2013-10-20

Central venous catheter- assisted abdominal drainage in treatment of intractable ascites: report of 36 cases

Department of Hepatology, Xingtai People's Hospital

摘要

摘要:
目的探讨采用腹腔穿刺置入中心静脉导管治疗顽固性腹水的疗效。方法选择2010年7月至2011年3月本科室经补充白蛋白及各种利尿剂治疗无效的肝硬化顽固性腹水患者36例,进行腹腔置管放液治疗,第1次放腹水一般不超过800 ml,此后每日放腹水量1500~2000 ml,联合输注人血白蛋白10 g/d。口服螺内酯400 mg/d,呋塞米160 mg/d,联合内科综合治疗。结果观察治疗12 d后的腹水消退情况、超声检查结果、尿量、稳定时间,治疗3 d后患者腹胀均得到缓解,12 d后显效17例(47.2%),有效15例(41.7%),无效4例(11.1%),总有效率达88.9%。结论中心静脉导管置入腹腔后,减少了穿刺次数,减少了肝肾综合征的发生,中心静脉导管腹腔持续引流操作简便,不良反应少,有利于顽固性腹水的治疗。
- 导管插入术,中心静脉 /
- 引流术 /
- 腹水
Abstract:
Objective To assess the therapeutic efficacy of central venous catheter placement via abdominal puncture in the treatment of refractory ascites. Methods Thirty- six patients with refractory ascites due to cirrhosis who were unresponsive to albumin supplement and diuretic treatment and admitted to our hospital from July 2010 to March 2011 were included in this study. Intraperitoneal catheter drainage was performed in these patients, in which generally not more than 800 ml of ascites was drained in the first session and subsequently 1500- 2000ml of ascites was drained daily; in addition, human albumin ( 10 g / d) was infused, and spironolactone ( 400 mg / d) and furosemide ( 160mg / d) were orally given. Results Reduction in ascites volume, ultrasound examination results, urine volume, and time of stable condition were monitored after 12 days of treatment. Abdominal distension was relieved in all patients after 3 days of treatment. After 12 days of treatment, 17 cases ( 47. 2%) showed a complete response, 15 cases ( 41. 7%) showed a partial response, and 4 cases ( 11. 1%) showed no response, with a response rate of 88. 9%. Conclusion The placement of a central venous catheter in the abdominal cavity reduces the number of punctures and lowers the incidence of hepatorenal syndrome. The central venous catheter offers a convenient, safe, and easy- to- use tool for sustained peritoneal drainage in the treatment of intractable ascites.
- catheterization, central venous /
- drainage /
- ascites

HTML全文

参考文献(7)

[1]ZHANG W, XU XP, QU ZS, et al.Central venous catheter dailydrainage in treating 35 cases of refractory ascites[J/CD].Chin J Liver Dis (Electron Vers) , 2009, 1 (2) :17-23. (in Chinese) 张炜, 徐小平, 瞿章书, 等.中心静脉导管每日引流法治疗35例难治性腹水[J/CD].中国肝脏病杂志 (电子版) , 2009, 1 (2) :17-23.

[2]ZHANG RF, LI YL.Abdominal indwelling catheter in treatment of 40cases of intractable ascites[J].J North China Coal Medical University, 2004, 6 (2) :165. (in Chinese) 张瑞凤, 李玉林.腹腔内留置导管治疗顽固性腹水40例体会[J].华北煤炭医学院学报, 2004, 6 (2) :165.

[3]XIANG Q, YUE GP, WANG YZ, et al.The change of blood pressure and discharge ascites hepatorenal syndrome[J].China Foreign Med Treat, 2010, 1 (2) :22-23. (in Chinese) 向谦, 岳广平, 王永占, 等.排放腹水前后血压变化与肝肾综合征的发生[J].中外医疗, 2010, 1 (2) :22-23.

[4]GINèS P, TITLL, ARROYO V, et al.Randomized comparative study of therapeutic paracentesis with and without intravenous albumin in cirrhosis[J].Gastroenterology, 1988, 94 (6) :1493-1502.

[5]GINS A, FERNNDEZ-ESPARRACH G, MONESCILLO A, et al.Randomized trial coparing albumin, dextran 70, and polygeline in cirrhotic patient with ascites treated by paracentesis[J].Gastroenterology, 1996, 111 (4) :1002-1010.

[6]GINS A, PLANAS R, ANGELI P, et al.Treatment of patients with cirrhosis and refractory ascites using the LeVeen shunt with titanium tip:coparison with therapeutic paracentesis[J].Hepatology, 1995, 22 (1) :124-131.

[7]RUNYON BA.Practice Guidelines Committee, American Association for the Study of Liver Diseases (AASLD) .Management of adult patients with ascites due to cirrhosis[J].Hepatology, 2004, 39 (3) :841-856.

施引文献

资源附件(0)

访问统计