自身腹水回输治疗肝硬化腹水机制的研究

目的 :探讨自身腹水回输治疗肝硬化腹水机制。方法 :将 40例常规治疗疗效不佳的肝硬化腹水病人随机分为两组 :实验组放腹水 2 0 0 0ml,其中 1 0 0 0ml静脉回输 ,再静脉注射速尿 6 0mg ;对照组放腹水 2 0 0 0ml,静脉点滴白蛋白 1 0g ,再静脉注射速尿 6 0mg。结果 :实验组术前、术后、术后第 4d血浆醛固酮 (ALD)、血浆心钠素 (ANF)、血浆内皮素 (ET)及术前、术后尿量、肾动脉血流量与对照组无明显差异 ;但是实验组血清白蛋白升高较稳定。结论 :自身腹水回输治疗肝硬化腹水的机制在于同时消除腹水和扩容两大治疗原则。由于有许多血管活性物质的参与 ,可能逆转了发生腹水的某些病理生理环节

Study on the Mechanism of Ascites Auto-transfusion Treatment for Hepatocirrhosis with Ascites

Objective:To study on the mechanism of ascites auto-transfusion treatment for hepatocirrhosis with ascites.Methods:40 cirrhosis patients with ascites who obtained unsatisfied effects after routine treatment were divided into experimental group and control group randomly.The 1000 ml ascites of 2000 ml discharged were auto-transfused and 60mg lasix was injected intravenously in experimental group.10g albumin was transfused after discharged 2000ml ascited and then 60mg lasix was injected intravenously.Results:There was no significant difference between the experimental group and control group in ALD,ANF,ET in plasma,amount of urea and blood flow in nephric artery pre-operation and post-operation.But albumin was increased more steadily in experimental group than in control group.Conclusion:The mechanism of ascites auto-transfusion treatment for hepatocirrhosis might lain in eliminating ascites and increasing hepatic capacity at same time.Some blood vessel active substances might reverse the pathological and physiological factors inducing ascites.