特利加压素联合腹水浓缩回输术治疗肝硬化并发顽固性腹水患者效果研究*

目的 观察采用腹水浓缩回输术联合特利加压素治疗肝硬化并发顽固性腹水(RA)患者的效果。方法 2016年5月～2021年5月我院诊治的62例肝硬化并发RA患者被随机分为对照组31例和观察组31例,分别给予腹水浓缩回输术或在此治疗的基础上应用特利加压素治疗7 d。使用全自动生化分析仪检测血尿素氮(BUN)和血肌酐(sCr),使用超声诊断仪测量门静脉内径(DPV)、脾静脉内径(DSV)、门静脉血流速度(VPV)和脾静脉血流速度(VSV],应用WHO生命质量测定简式量表(WHOQOL-BREF)评估生命质量。结果 在治疗7d后,观察组腹围为(85.5±4.5)cm,腹水深度为(35.2±3.4)mm,均显著小于对照组【分别(88.4±4.3)cm和(47.2±5.1)mm,P<0.05】,24 h尿量为(1530.8±30.2)ml,显著多于对照组【(1248.6±28.4)ml,P<0.05】;观察组血清BUN和sCr水平分别为(6.6±1.5)μmol/L和(104.2±8.7)μmol/L,显著低于对照组【分别为(9.8±2.4)μmol/L和(133.5±11.2)μmol/L,P<0.05】,而两组肝功能指标比较,无显著性差异(P>0.05);观察组VPV为(25.7±5.4)cm/s,显著高于对照组【(22.5±4.6)cm/s,P<0.05】,而两组DPV、DSV和VSV比较,差异无统计学意义(P>0.05);观察组WHOQOL-BREF评分总分为(65.6±12.3)分,显著高于对照组【(56.1±9.8)分,P<0.05】。结论 采用腹水浓缩回输术联合特利加压素治疗肝硬化并发RA患者近期疗效较好,可显著改善肾功能,促进腹水消退,继而改善生命质量。

Seven-day observation of concentrated ascites reinfusion and terlipressin combination therapy in the treatment of patients with liver cirrhosis and refractory ascites

Objective The aim of this study was to observe the very short-term efficacy of concentrated ascites reinfusion (CAR) and terlipressin combination therapy in the treatment of patients with liver cirrhosis (LC) and refractory ascites (RA). Methods 62 patients with LC and RA were admitted to our hospital between May 2016 and May 2021, and were randomly divided into control (n=31) and observation group (n=31). The patients in the control group were treated with CAR, and those in the observation group were treated with CAR and terlipressin combination. The regimen lasted for 7 days in the two groups. The blood urea nitrogen (BUN) and serum creatinine (sCr) levels were detected by an automatic biochemical analyzer. The diameter of portal vein (DPV), the diameter of splenic vein (DSV), the velocity of portal vein (VPV) and the velocity of splenic vein (VSV) were measured with ultrasonography. The WHO quality of life (WHOQOL-BREF) questionnaire was applied to evaluate the quality of life (QOL). The abdominal circumference, depth of ascites, 24 hour urine volume and the incidence of adverse reactions were recorded. Results At the end of 7 day treatment, the abdominal circumference was (85.5±4.5)cm, and the depth of ascites was (35.2±3.4)mm, both significantly smaller than [(88.4±4.3)cm and (47.2±5.1)mm, respectively, P<0.05], while the 24 hour urine volume was (1530.8±30.2)ml, significantly greater than [(1248.6±28.4)ml, P<0.05] in the control; the BUN and sCr levels were (6.6±1.5)μmol/L and(104.2±8.7)μmol/L, both significantly lower than [(9.8±2.4)μmol/L and (133.5±11.2)μmol/L, respectively, P<0.05] in the control, while there was no significant difference respect to liver function tests in the two groups (P>0.05); the VPV was (25.7±5.4)cm/s, significantly higher than [(22.5±4.6)cm/s, P<0.05] in the control, while there were no significant differences respect to DPV, DSV and VSV in the two groups(P>0.05); the total WHOQOL-BREF score was (65.6±12.3), significantly higher than [(56.1±9.8), P<0.05] in the control. Conclusion The CAR and terlipressin combination therapy in the treatment of patients with LC and complicated RA is relatively efficacious, from the point of view of the very short-time, which could improve kidney functions and promote ascites subsided, thereby improve the quality of life.