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目的观察前列地尔联合中心静脉导管腹腔引流治疗顽固性腹水的疗效。方法入组患者随机分为两组。对照组(30例)在内科保肝、利尿等综合治疗基础上腹腔置管放液,首次放腹水少于800 ml,以后每天1 500~2 000 ml,同时每天静滴人血白蛋白10 g,疗程21天。治疗组(30例)在对照组治疗基础上加用前列地尔10μg/d静脉点滴,疗程21天。结果所有患者治疗后腹胀较前缓解,尿量增多。治疗组患者总有效率(80%)优于对照组(40%),差异有统计学意义(χ2=10.0,P=0.001)。治疗组治疗前后谷丙转氨酶(ALT)分别为(145.00±14.25)U/L及(83.49±12.44)U/L(t=44.166,P=0.000),总胆红素(TBil)分别为(76.20±5.85)μmol/L及(38.49±3.11)μmol/L(t=29.048,P=0.000),血清肌酐(SCr)分别为(124.83±7.29)μmol/L及(83.98±7.58)μmol/L(t=29.019,P=0.000),差异均有统计学意义。对照组治疗前后ALT、TBil、SCr相比较,差异均有统计学意义,分别为t=19.819,P=0.000;t=10.820,P=0.000;t=12.534,P=0.000。治疗后两组ALT、TBil、SCr相比较,差异均有统计学意义,分别为t=4.564,P=0.000;t=7.073,P=0.000;t=14.127,P=0.000。结论前列地尔联合中心静脉导管腹腔引流治疗顽固性腹水有一定疗效。
Objective To observe the curative effect of intraperitoneal drainage of alprostadil combined with central venous catheter in treatment of refractory ascites. Methods Patients were randomly divided into two groups. The control group (30 cases) was treated by peritoneal catheterization on the basis of comprehensive treatment such as liver protection and diuresis. The first ascitic fluid was less than 800 ml and the later was 1 500 ~ 2 000 ml. Meanwhile, the daily intravenous infusion of human serum albumin 10 g , Treatment for 21 days. Treatment group (30 cases) in the control group based on the treatment with alprostadil 10μg / d intravenous drip for 21 days. Results All patients experienced more severe abdominal distension and increased urine output after treatment. The total effective rate (80%) in the treatment group was better than that in the control group (40%), the difference was statistically significant (χ2 = 10.0, P = 0.001). The levels of ALT before and after treatment in the treatment group were (145.00 ± 14.25) U / L and (83.49 ± 12.44) U / L respectively, and the total bilirubin (TBil) Serum creatinine were (124.83 ± 7.29) μmol / L and (83.98 ± 7.58) μmol / L respectively (± 5.85) μmol / L and (38.49 ± 3.11) μmol / t = 29.019, P = 0.000), the differences were statistically significant. The differences of ALT, TBil and SCr before and after treatment in the control group were statistically significant, t = 19.819, P = 0.000; t = 10.820, P = 0.000; t = 12.534, P = 0.000. After treatment, the differences of ALT, TBil and SCr between the two groups were statistically significant, t = 4.564, P = 0.000; t = 7.073, P = 0.000; t = 14.127, P = 0.000. Conclusion Alprostadil combined with central venous catheter drainage of refractory ascites has some effect.