经腹深静脉导管引流治疗肝硬化难治性腹水

目的：探讨经皮腹腔穿刺置入深静脉导管引流在腹腔积液治疗中的效果。方法：130例肝硬化失代偿期患者分为两组，观察组68例行经皮腹腔穿刺置入深静脉导管引流腹腔积液，对照组62例予传统腹腔穿刺抽液，治疗3d后观察治疗效果及不良反应。结果：两组治疗后体重下降，腹围减小，24h尿量增加，且观察组优于对照组。治疗前后血清谷丙转氨酶、总胆红素无明显变化；治疗后血清总蛋白、白蛋白浓度增高，血肌酐及尿素氮水平降低，两组相比差异无统计学意义（P〉0．05）；两组血K^＋，Na^＋，Cl^-等电解质变化差异无统计学意义（P〉0．05）；观察组临床缓解率97％，对照组68％，差异有统计学意义（P〈0．01）；观察组不良反应发生率3％，明显低于对照组29％，差异有统计学意义（P〈0．01）。结论：经皮腹腔穿刺置入深静脉导管引流较腹腔穿刺抽液治疗腹腔积液具有简单、方便、安全、创伤少、不易感染、治疗效果好等优点。

Application of drainage with central venous catheteriazation set in hepatic cirrhosis patients with refractory ascites

Objective To examine the clinical effective rate of drainage with central venous catheteriazation set in hepatic cirrhosis patients with refractory ascites.Methods One hundred and thirty hepatic cirrhosis patients were divided into two groups,62 patients in control group and 68 patients in the observed group.The observed group was treated with percutaneous abdominal paracentesis by using central venous catheteriazation set,the other patients in control group were treated with routine abdominal paracentesis.The clinical effect and the adverse reactions were observed.Results Decreasing of the weight,abdominal perimeter and increasing of urine volume per 24 hours occurred in the two groups.There was a statistic difference between the two groups(P<0.01).The glutamic-pyruvic transaminase and the total bilirubin did not change obviously after treatment(P>0.05)in both groups.After treatment,the total protein and albumen of plasma increased(P<0.01),while the levels of the ureanitrogen and Cr decreased(P<0.01),and the electrolyte did not change(P>0.05).There was no statistic difference between the two groups(P>0.05)by compared with these items.The clinical effective rate was 97% in the observed group,higher than that in control group(68%)(P<0.01).The adverse reaction rate was 3% in the observed group,lower than that in control group(29%)(P<0.01).Conclusion Compared with routine abdominal paracentesis,drainage with central venous catheteriazation set is an easy,safe,and effective method for hepatic cirrhosis patients with refractory ascites,with tiny trauma and no inflammation.