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目的评估肝硬化合并难治性腹水患者经腹腔大量穿刺放液后(LVP)输注人血白蛋白的疗效。方法 84例肝硬化难治性腹水患者,采用抛硬币法分为对照组和治疗组,每组42例。对照组患者采用常规治疗,治疗组患者采用常规治疗联合大量排放腹水加输注白蛋白方法。观察两组腹水治疗效果及并发症发生率。结果治疗组腹水减少显效时间、住院时间分别为(10.0±3.8)、(12.1±2.6)d,均明显短于对照组的(20.0±4.7)、(26.0±3.6)d,差异有统计学意义(P<0.05);治疗组腹水消退32例,腹静脉怒张改善28例,明显优于对照组的21、11例,差异均有统计学意义(P<0.05)。治疗组治疗总有效率为85.7%,高于对照组的40.8%,并发症发生率为19.0%,低于对照组的59.5%,差异均具有统计学意义(P<0.05)。结论常规治疗联合大量排放腹水结合输注白蛋白方法治疗肝硬化难治性腹水的效果显著,有利于患者临床恢复,且操作简单,经济实用,安全方便,适合基层医院使用,值得临床推广和应用。
Objective To evaluate the efficacy of transfusion of human serum albumin after transabdominal massive puncture and release (LVP) in patients with cirrhosis and refractory ascites. Methods Eighty - four patients with cirrhosis and refractory ascites were divided into control group and treatment group by coin - tossing method, with 42 cases in each group. Patients in the control group were treated with conventional therapy, and patients in the treatment group were treated with conventional therapy combined with massive ascites discharge plus albumin infusion. The therapeutic effects and complication rates of two groups were observed. Results The ascites decreased significantly in the treatment group (10.0 ± 3.8) and (12.1 ± 2.6) d, which were significantly shorter than those in the control group (20.0 ± 4.7) and (26.0 ± 3.6) days, respectively, with significant difference (P <0.05). In the treatment group, 32 cases of ascites subsided and 28 cases of abdominal venous distention were improved, which was significantly superior to that of the control group (21,11 cases). The difference was statistically significant (P <0.05). The total effective rate of the treatment group was 85.7%, higher than that of the control group 40.8%, complication rate 19.0%, lower than the control group 59.5%, the difference was statistically significant (P <0.05). Conclusion The combination of conventional therapy with massive discharge of ascites and albumin infusion in the treatment of cirrhosis-refractory ascites has significant effect, which is beneficial to the clinical recovery of patients with cirrhosis, and is simple and practical, economical and practical, safe and convenient, suitable for primary hospital, is worthy of clinical promotion and application .