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目的探讨肝硬化难治性腹水应用LVP联合静脉滴注白蛋白、右旋糖酐40治疗的效果。方法全部患者绝对卧床休息,有消化道出血者给予降低门脉压力、止血治疗,限盐、限水,纠正电解质紊乱及综合护肝疗法的同时给予利尿剂,剂量均调整为:安体舒通40～80mg,3次/d口服,呋塞咪20～40mg,2次/d静脉注射,有肝硬化合并症者均予相应的处理。结果本组45例中,显效30例,有效12例,无效3例。结论肝硬化难治性腹水的治疗是多方面的,应综合分析,全面评估。LVP联合静脉补充白蛋白、右旋糖酐40治疗是一种有效的治疗肝硬化腹水的方法。与传统利尿剂联合静脉滴注白蛋白疗法相比较,它具有疗效好、经济和住院时间短的特点,值得临床应用。
Objective To investigate the effect of intravenous infusion of albumin and dextran 40 in the treatment of refractory ascites caused by cirrhosis. Methods All patients with absolute rest in bed, patients with gastrointestinal bleeding were given reduced portal pressure, hemostasis, salt restriction, water limitation, electrolyte imbalance correction and integrated liver protection therapy given diuretics, the dose were adjusted as: spironolactone 40 ~ 80mg, 3 times / d oral, furosemide 20 ~ 40mg, 2 times / d intravenous injection, patients with cirrhosis were treated accordingly. Results 45 cases in this group, markedly effective in 30 cases, effective in 12 cases, 3 cases. Conclusion The treatment of cirrhosis refractory ascites is multifaceted and should be comprehensively analyzed and fully evaluated. LVP combined with intravenous albumin, dextran 40 treatment is an effective method of treatment of cirrhosis and ascites. Compared with traditional diuretic combined intravenous albumin therapy, it has the characteristics of good curative effect, economical and short hospital stay, which is worthy of clinical application.