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前列地尔联合中心静脉导管腹腔引流治疗顽固性腹水

作者：刘运龙刘英果付春生

单位：聊城市传染病医院山东聊城 252000

关键词：前列地尔肝硬化顽固性腹水

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出版年,卷(期):页码：2015,7(2):56-58

摘要：

摘要：目的观察前列地尔联合中心静脉导管腹腔引流治疗顽固性腹水的疗效。方法入组患者随机分为两组。对照组（30例）在内科保肝、利尿等综合治疗基础上腹腔置管放液，首次放腹水少于800 ml，以后每天1 500～2 000 ml，同时每天静滴人血白蛋白10 g，疗程21天。治疗组（30例）在对照组治疗基础上加用前列地尔10 μg/d静脉点滴，疗程21天。结果所有患者治疗后腹胀较前缓解，尿量增多。治疗组患者总有效率（80%）优于对照组（40%），差异有统计学意义（χ2 = 10.0，P = 0.001）。治疗组治疗前后谷丙转氨酶（ALT）分别为（145.00 ± 14.25）U/L及（83.49 ± 12.44）U/L（t = 44.166，P= 0.000），总胆红素（TBil）分别为（76.20 ± 5.85）μmol/L及（38.49 ± 3.11）μmol/L（t = 29.048，P = 0.000），血清肌酐（SCr）分别为（124.83 ± 7.29）μmol/L及（83.98 ± 7.58）μmol/L（t =29.019，P = 0.000），差异均有统计学意义。对照组治疗前后ALT、TBil、SCr相比较，差异均有统计学意义，分别为t = 19.819，P = 0.000；t = 10.820，P = 0.000；t = 12.534，P = 0.000。治疗后两组ALT、TBil、SCr相比较，差异均有统计学意义，分别为t = 4.564，P = 0.000；t = 7.073，P = 0.000；t= 14.127，P = 0.000。结论前列地尔联合中心静脉导管腹腔引流治疗顽固性腹水有一定疗效。

Abstract: Objective To assess the efficacy of prostaglandin E1 (PGE1) and central venous catheter placement via abdomintal puncture in the treatment of refractory ascites. Methods All enrolled patients were randomly divided into two groups: treatment group (30 cases) and control group (30 cases). Intraperitoneal catheter drainage was performed in all 60 patients, generally no more than 800 ml ascites were drained in the first session and subsequently 1 500-2 000 ml ascites daily; in addition, human albumin (10 g/d) was infused for 21 days. Besides the meaures obove, PGE1 was given through intravenous drip (10 μg/d) for 21 days in the treatment group. Results Abdominal distension was relieved in all patients after treatment. The response rate in treatment group was higher than that in control group, with significant difference (P = 0.001). Liver function and renal function of patients in treatment group was statistically significant compared to those of untreatment, ALT (t = 44.166, P = 0.000), TBil (t = 29.048, P = 0.000), SCr (t = 29.019, P = 0.000). ALT,
TBil, SCr also decreased in the control group compared to those of untreatment (t = 19.819, P = 0.000；t = 10.820, P = 0.000；t = 12.534, P = 0.000). The changes of ALT, TBil, SCr in the two groups after treatment were significant (t = 4.564, P = 0.000；t = 7.073, P = 0.000；t = 14.127, P = 0.000). Conclutions PGE1 and central venous catheter placement via abdomintal puncture may have certain therapeutic effect for patients of liver cirrhosis with refractory ascites.

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