Paracentesis vs. intraperitoneal reinfusion of concentrated ascites — effect on opsonic activity of ascites

Background. Spontaneous bacterial peritonitis is a frequent and serious complication of cirrhotic ascites. An important defense mechanism of ascites against infection is opsonic activity, where the most important part is played by specific antibodies and C3 and C4 components of complement. The authors wanted to find out whether reinfusion of concentrated ascites or paracentesis can influence this activity. Methods. Twenty-six patients with cirrhosis of the liver and refractory ascites not corresponding to salt restriction and diuretics were divided into two groups. In 14 patients, a total of 25 therapeutic paracenteses were made; in 12 patients, a total of 19 reinfusions of concentrated ascites were performed intraperitoneally. In all patients, levels of IgG, IgA, IgM, C3 and C4 components of complement were assessed in ascites before and 24 h after the intervention. Results. After paracentesis no change of the investigated parameters was found. Reinfusion of concentrated ascites, on the other hand, led to a significant rise of IgG, IgA, IgM, C3 and C4 at the 0.5% level of significance. Conclusion. Treatment of refractory ascites by ultrafiltration and reinfusion intraperitoneally seems to increase opsonic activity of ascites and could be useful in the prevention of the development of spontaneous bacterial peritonitis.     

模拟机下细针经皮肺穿刺(附53例临床分析)

目的探讨模拟机下细针经皮肺穿刺对肺部周围型病变诊断的价值.方法对53例肺部周围型占位性病变患者在模拟机下应用细针穿刺取材涂片,行细胞学检查.结果 53例患者均穿刺成功,获得细胞学资料, 总阳性率为90.5%(48/53).其中44例患者涂片找到肿瘤细胞,非癌诊断者4例.出现并发症7例(13.2%),其中气胸4例(7.5%),咯血3例(5.7%),血量少(＜50ml),常规处理后好转.结论模拟定位机下细针经皮肺穿刺是一种快速、简便、安全和实用的诊断技术,且并发症少,它减少了开胸探查术,可在有条件的单位开展.     

前房穿刺联合甲基纤维素在小梁切除术中的应用

目的探讨前房穿刺联合甲基纤维素在小梁切除术中的应用及术后效果。方法采用小梁切除术并前房穿刺联合甲基纤维素对69例(78眼)青光眼进行了手术治疗。手术过程中,通过前房穿刺口放出房水,注入平衡液促使前房形成,巩膜瓣下注入少量甲基纤维素,防止浅前房、滤过泡瘢痕化发生。结果术中78眼均人工形成前房。出院时眼压均在正常范围内,经3个月~2年随访观察,均形成良好功能滤过泡。结论前房穿刺联合甲基纤维素在小梁切除术中的应用,可以减轻手术并发症,提高了手术成功率。