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1、血液透析联合腹水回输治疗顽固性腹水的临床观察［摘要］目的探讨血液透析并腹水静脉回输在尿毒症顽固性腹水患者中的临床疗效。方法回顾性研究2010年10月至2013年9月在我科接受血液透析并腹水静脉浓缩回输治疗的尿毒症患者，11例，41例次,通过分析比较治疗前后体重、腹围、血压、血浆白蛋白、尿素氮、肌肝等各项指标的变化，探讨血液透析并腹水静脉回输在尿毒症顽固性腹水患者屮的临床疗效。结果1例行2次治疗后腹水消失，1例行7次治疗后胸腔积液及腹水均消失，水肿消退，11例患者治疗后均有明显效果，表现为腹胀、活动受
2、限等腹水压迫症状明显改善，浮肿消失，夜间阵发性呼吸困难、睡眠明显好转，食欲增加，腹围、体重明显减少（P〈0.05）,血浆尿素氮、肌肝明显下降（P〈0.01）,血浆白蛋白明显升高（P〈0・01）。结论血液透析并腹水静脉回输能显著改善尿毒症并顽固性腹水患者的临床症状，提高其生存质量，延长生存时间，临床疗效确切。［关键词］血液透析；腹水静脉回输；顽固性腹水；尿毒症［中图分类号］R459.5［文献标识码］B［文章编号］1673-9701（2014）31-0151-03Clinicalobservationo
3、fhemodialysiscombinedwithascitesreinfusionintreatmentofrefractoryascitesWANGJipingWULihuaZHUJunyaBloodPurifyingCenter,NongkenCentralHospitalinGuangdongProvince,Zhanjiang524000,China[Abstract]ObjectiveToinvestigatetheclinicalefficacyofhemodialysiscombin
4、edwithintravenousascitesreinfusioninthetreatmentofpatientswithuremiaassociatedwithrefractoryascites・MethodsElevenpatients(41person-times)withuremiawhoreceivedhemodialysiscombinedwithintravenousascitesreinfusiontreatmentinourdepartmentfromOctober2010toS
5、eptember2013wereanalyzedretrospectively.Throughanalyzingandcomparingthechangesinweight,abdominalgirth,bloodpressure,plasmaalbumin,ureanitrogen,creatinineandotherindicatorsbetweenbeforeandafterthetreatment,theclinicalefficacyofhemodialysiscombinedwithin
6、travenousascitesreinfusionforthepatientswithuremicrefractoryasciteswasinvestigated.ResultsAscitesof1patientdisappearedafter2timesoftreatment；Pleuraleffusionandascitesof1patientdisappearedandedemafadedawayafter7timesoftreatment；Thetreatmenteffectswereob
7、viousfor11patients,manifestingasobviousimprovementofabdominaldistension,motionlimitationandotherascitespressuresymptoms,significantimprovementofedema,paroxysmalnocturnaldyspneaandsleep,increasedappetite,obviousdecreaseofabdominalgirthandweight(P<0.01),
8、significantdecreaseofplasmaureanitrogenandcreatinine(P<0.01),andsignificantincreaseofplasmaalbumin（P〈0・01）・ConclusionHemodialysiscombinedwithintravenousascitesreinfusioncansignificantlyimprovetheclinicalsymptomsofthepatientswithuremiaas
