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目的探讨腹水静脉回输在重症布加综合征治疗中的方法及意义。方法 2006年3月至2009年7月期间在第二炮兵总医院对18例重症或复发的布加综合征患者给予腹水静脉回输治疗,对治疗前、后患者一般情况、肝肾功能、凝血功能和电解质检测结果以及疗效进行分析。结果腹水回输量5000～7800ml,平均6940ml,患者腹水回输过程中无明显并发症发生。与治疗前比较,患者腹围明显减小(P<0.05),体重无明显变化,24h尿量有增多趋势(P>0.05)。患者治疗后血清总蛋白、白蛋白明显提高(P<0.05),尿素氮及肌酐明显下降(P<0.05),患者肝、肾功能均获不同程度好转。血浆凝血酶原时间(PT)和活化的部分凝血活酶时间(APTT)明显缩短(P<0.05),血清电解质无明显变化(P>0.05)。治疗后所有患者随访4～37个月,平均19个月。其中12例在治疗3～6个月后,因可以耐受手术而再次手术治疗。结论腹水静脉回输对重症布加综合征是一种安全、有效的治疗方法,可以明显改善患者的生活质量,为后续治疗赢得了机会。
Objective To investigate the method and significance of ascites intravenous infusion in the treatment of severe Budd-Chiari syndrome. Methods From March 2006 to July 2009, 18 patients with severe or recurrent Buddard syndrome in the Second Artillery General Hospital were treated with intravenous infusion of ascites. The changes of the general condition, liver and kidney function, coagulation Functional and electrolyte test results and efficacy were analyzed. Results The amount of ascites transfusion 5000 ~ 7800ml, an average of 6940ml, patients with ascites return process no significant complications. Compared with before treatment, abdominal circumference was significantly reduced (P <0.05), no significant changes in body weight, 24h urine output increased (P> 0.05). After treatment, serum total protein and albumin were significantly increased (P <0.05), and urea nitrogen and creatinine were significantly decreased (P <0.05). The liver and kidney function were improved in varying degrees. Plasma prothrombin time (PT) and activated partial thromboplastin time (APTT) were significantly shortened (P <0.05), serum electrolytes did not change significantly (P> 0.05). After treatment, all patients were followed up for 4 to 37 months, an average of 19 months. Twelve of these patients were treated surgically after 3 to 6 months of treatment because they were able to tolerate surgery. Conclusion Ascites venous return is a safe and effective treatment for severe Budd-Chiari syndrome, which can significantly improve the quality of life of patients and win the opportunity for follow-up treatment.