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腹腔-静脉分流术和腹水回输术已被公认为治疗难治性腹水的有效方法。但有报道上述治疗方法均可引起明显的凝血障碍,其机理仍不明。本文通过检测腹水回输前后凝血和纤维蛋白溶解的变化来探讨凝血障碍的发生机制。研究对象为16例利尿剂治疗无效的肝硬化门脉高压腹水患者。腹水回输术按通常介绍的方法进行,腹水回输速率为600～800 ml/h,回输时间常持续8～24小时,腹水消除平均为6.9 L(2.5～14.0 L)。所有患者在接受此疗法前均作细菌学和细胞学常规检查,并分别于腹水回输前、开始后5 h和翌晨采取血标本。此外腹水及浓缩腹水则分别于回输前和回输开始后4～5 h采集。
Intraperitoneal-venous shunts and ascites transfusions have been recognized as effective methods for the treatment of refractory ascites. However, it has been reported that the above treatment methods can cause obvious coagulation disorders, the mechanism remains unclear. This article examines the coagulation disorders by detecting changes in coagulation and fibrinolysis before and after transfusion of ascites. The study included 16 patients with cirrhosis and portal hypertension who had ineffective diuretic therapy. The ascites transfusion is performed according to the method generally described. The rate of ascites transfusion is 600-800 ml / h. The time of transfusion usually lasts for 8-24 hours and the average of ascites elimination is 6.9 L (2.5-14.0 L). All patients underwent routine bacteriological and cytological examinations prior to receiving this therapy, and blood samples were taken at 5 h and one morning after onset of ascites resuscitation. In addition, ascites and concentrated ascites were collected 4 and 5 h before and after the start of reinfusion.