人血白蛋白联合高渗氯化钠序贯治疗肝硬化腹水并低渗性脑病的临床观察

目的　探讨人血白蛋白联合高渗氯化钠序贯治疗对肝硬化腹水并低渗性脑病的影响。方法　将 2 3例腹水并低渗性脑病患者随机分为治疗组 (12例 )和对照组 (11例 )。两组均予限水、输注人血白蛋白、利尿治疗 ,在此基础上 ,治疗组联合 3 %氯化钠序贯治疗 ,观察两组病人精神症状、渗透压、尿量、血钠、病死率等参数的变化。结果　治疗组所有患者精神症状迅速消失 ,无一例死亡。而对照组有 11例精神症状有明显减轻外 ,无一例患者症状完全消失 ,病死率为2 7.2 7%。两组疗效比较差异有高度显著性 (P <0 .0 1)。治疗组血浆渗透压、血钠、尿量各项指标均得到明显改善 ,与对照组比较差异有高度显著性 (P均 <0 .0 1)。结论　人血白蛋白联合高渗氯化钠序贯治疗肝硬化腹水并低渗性脑病 ,能迅速消除患者的精神症状 ,疗效确切 ,可作为常规治疗方法。

Clinical observation on human serum albumin combined with hypertonic sodium chloride in sequential therapy for ascites due to cirrhosis associated with hypotonic encephalopathy

Objective To evaluate the effic ac y of human serum albumin combined with hypertonic sodium chloride in sequential treatment of ascites due to cirrhosis associated with hypotonic encephalopathy. Methods 23 patients with ascites associated wi th hypotonic encephalopathy were randomly divided into a therapeutic group (n =12) and a control group (n=11). Both groups were given the treatment wit h water l imited, injecting human serum albumin and diuresis; based on the above treatment , the therapeutic group received additional sequential treatment with 3% sodiun chloride. The mental symptom, osmotic pressure, urine volume, blood sodium and t he death rate indexes in the two groups were observed. Results In the therapeutic group, all the pati ents' mental sympton disappeared completely and rapidly, no death. In the contro l group, the mental sympton in 11 of which improved, non of the mental sympton d isappeared completely, the death rate was 27.27%. There was statistically signi ficant differences in comparison of the effectiveness in these two groups (P <0.0 1). The plasma osmotic pressure, blood sodium and urine volume indexes were sign ificantly improved and in comparison to the control group, there were statistica lly significant differences (all P<0.01). Conclusion Human serum albumin combined with h ypertonic sodium chloride are effective in sequential treatment of ascites due t o cirrhosis associated with hypotonic encephalopathy.