血液透析滤过联合腹腔积液浓缩回输治疗肝肾综合征疗效观察

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目的:观察血液透析滤过联合腹腔积液浓缩回输治疗肝肾综合征的疗效。方法:将肝肾综合征27例随机分为观察组14例和对照组13例,对照组采用单纯腹腔积液浓缩回输治疗,观察组采用血液透析滤过联合腹腔积液浓缩回输治疗,比较两组肝肾功能、尿量等指标变化及治疗后3个月生存率。结果:观察组3个月生存率显著高于对照组(P<0.05)。两组治疗前血清钾、钠、尿素氮、肌酐、胆红素水平及24h尿量差异不显著(P>0.05);治疗后观察组血清钾、尿素氮、肌酐和胆红素水平均显著低于对照组(P<0.05),血清钠水平显著高于对照组(P<0.05)。治疗后两组血清清蛋白水平均较治疗前升高,两组比较,差异不显著(P>0.05)。治疗后两组尿量都显著增加,但观察组尿量增加更显著(P<0.05)。结论:采用血液透析滤过联合腹腔积液浓缩回输治疗肝肾综合征,疗效优于单纯腹腔积液浓缩回输治疗。 Objective: To observe the therapeutic effect of hemodiafiltration combined with pleural effusion concentration and reinfusion in the treatment of hepatorenal syndrome. Methods: Twenty-seven patients with hepatorenal syndrome were randomly divided into observation group (n = 14) and control group (n = 13). The control group was treated with simple ascitic fluid concentration and reinfusion. The observation group was treated by hemodialysis combined with peritoneal effusion concentration- The liver and kidney function, urine output and other indicators of changes in the two groups and 3 months after treatment survival rate. Results: The 3-month survival rate in the observation group was significantly higher than that in the control group (P <0.05). The levels of serum potassium, sodium, urea nitrogen, creatinine, bilirubin and 24h urine before treatment were not significantly different between the two groups (P> 0.05). After treatment, the levels of serum potassium, urea nitrogen, creatinine and bilirubin in the observation group were significantly lower In the control group (P <0.05), serum sodium level was significantly higher than that in the control group (P <0.05). Serum albumin levels in both groups increased after treatment compared with before treatment, the difference was not significant (P> 0.05). Urine volume increased significantly in both groups after treatment, but urine volume increased more significantly in observation group (P <0.05). Conclusion: Hemodialysis combined with transfusion of pleural effusion concentrated in the treatment of hepatorenal syndrome, the effect is better than simple ascites effusion treatment.
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