奧曲肽聯合中心靜脈導管腹腔引流治療肝硬化頑固性腹水療效觀察
藥物與臨床
作者：許飛等
[摘要] 目的 觀察奧曲肽聯合中心靜脈導管腹腔引流治療肝硬化頑固性腹水療效。 方法 將80例肝硬化頑固性腹水患者隨機分為兩組：治療組40例，在常規治療基礎上加用奧曲肽聯合中心靜脈導管腹腔引流治療；對照組40例，在常規治療基礎上，采用中心靜脈導管腹腔引流治療。療程均為2周。 結果 治療組顯效21例，有效13例，無效6例，總有效率85.0%；對照組顯效8例，有效13例，無效19例，總有效率52.5%。兩組比較差異有統計學意義（P
[關鍵詞] 肝硬化；頑固性腹水；奧曲肽；中心靜脈導管腹腔引流
[中圖分類號] R575.2 [文獻標識碼] B [文章編號] 1673-9701（2015）08-0096-03
[Abstract] Objective To observe the curative effects of octreotide combined with intraperitoneal drainage by central venous catheter in the treatment of cirrhosis complicated with refractory ascites. Methods Eighty patients with cirrhosis complicated with refractory ascites were randomly assigned to two groups. 40 patients in the treatment group， on the basis of regular treatment， received the treatment of octreotide combined with intraperitoneal drainage by central venous catheter； 40 patients in the control group， on the basis of regular treatment， received intraperitoneal drainage by central venous catheter. The course of treatment was 2 weeks. Results In the treatment group， 21 patients were significantly effective， 13 patients were effective， and 6 patients were ineffective. The total effective rate was 85.0%. In the control group， 8 patients were significantly effective， 13 patients were effective， and 19 patients were ineffective. The total effective rate was 52.5%. The differences between the two groups were statistically significant （P
[Key words] Cirrhosis； Refractory ascites； Octreotide； Intraperitoneal drainage by central venous catheter
腹水是肝硬化最常見的並發症，難治性腹水是指對限鈉和使用大劑量利尿劑無應答，或因嚴重不良反應而不能使用利尿劑者[1，2]。頑固性腹水是肝硬化晚期的嚴重表現，腹腔穿刺大量放腹水術後腹水早期複發率高，且易誘發Ⅰ型RHS、肝性腦病和消化道出血等並發症，預後不良[3]。由於造成肝硬化頑固性腹水主要原因為低蛋白血症和門脈高壓難以糾正，因而常規或者非常規的利尿劑、腹水回輸等對肝硬化頑固性腹水的治療並不能達到令人滿意的效果。因此臨床上常給予肝硬化頑固性腹水患者放出大量的腹水並給予常規治療聯合白蛋白輸注進行治療，並取得了較好的臨床療效。但是白蛋白的價格較為昂貴，較多患者由於經濟原因不能達到及時治療。因此本文選取80例肝硬化頑固性腹水患者為研究對象，對奧曲肽聯合中心靜脈導管腹腔引流治療肝硬化頑固性腹水療效進行了探究。現報道如下。