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目的 :探讨自身腹水回输治疗肝硬化腹水机制。方法 :将 40例常规治疗疗效不佳的肝硬化腹水病人随机分为两组 :实验组放腹水 2 0 0 0ml,其中 1 0 0 0ml静脉回输 ,再静脉注射速尿 6 0mg ;对照组放腹水 2 0 0 0ml,静脉点滴白蛋白 1 0g ,再静脉注射速尿 6 0mg。结果 :实验组术前、术后、术后第 4d血浆醛固酮 (ALD)、血浆心钠素 (ANF)、血浆内皮素 (ET)及术前、术后尿量、肾动脉血流量与对照组无明显差异 ;但是实验组血清白蛋白升高较稳定。结论 :自身腹水回输治疗肝硬化腹水的机制在于同时消除腹水和扩容两大治疗原则。由于有许多血管活性物质的参与 ,可能逆转了发生腹水的某些病理生理环节
Objective: To investigate the mechanism of ascites reinfusion in the treatment of cirrhosis and ascites. Methods: Forty patients with cirrhosis and ascites who had poor curative effect were randomly divided into two groups: experimental group ascites water 200ml, of which 100ml intravenous infusion, then intravenous furosemide 60mg; control group Ascites 200ml, intravenous albumin 10g, then intravenous furosemide 60mg. Results: The levels of plasma aldosterone (ALD), plasma ANP, ET, preoperative and postoperative urinary volume, renal artery blood flow in the experimental group were significantly higher than those in the control group No significant difference; but experimental group serum albumin increased more stable. Conclusion: The mechanism of self ascites reinfusion in the treatment of ascites due to cirrhosis is to eliminate the two principles of treatment of ascites and dilatation. The involvement of many vasoactive substances may reverse certain pathophysiological aspects of ascites