改良腹腔穿刺置管引流术联合腹腔内注射托拉塞米、多巴胺治疗肝硬化并难治性腹水的临床效果

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摘要目的探讨改良腹腔穿刺置管引流术联合腹腔内注射托拉塞米、多巴胺治疗肝硬化并难治性腹水的临床效果。方法选取我院2016年1月～2017年12月在消化科住院的60例肝硬化并难治性腹水患者作为研究对象，随机分为对照组（30例）和观察组（30例）。对照组给予常规护肝、降酶、利尿消肿、补充蛋白及维持电解质平衡等治疗措施，对于病毒性肝炎患者予以抗病毒治疗，行改良中心静脉导管腹腔置管引流术。观察组在对照组的基础上同时隔日腹腔注射盐酸多巴胺20 mg、托拉塞米20～40 mg，比较两组的治疗效果。结果观察组的总有效率为90%，高于对照组的50%，差异有统计学意义（P＜0.05）。观察组的肝功能各项指标改善情况优于对照组，差异有统计学意义（P＜0.05）。结论改良腹腔穿刺置管引流术联合腹腔内注射托拉塞米、多巴胺治疗肝硬化并难治性腹水能够协同提高临床治疗效果，值得进一步推广应用。

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	赖建荣
	易培庄
	周启明
	陈远辉
	段小萍

关键词 ：肝硬化, 难治性腹水, 腹腔内注射, 托拉塞米, 多巴胺

Abstract：Objective To investigate the clinical efficacy of modified abdominal puncture drainage combined with intraperitoneal injection of Torsemide and Dopamine in the treatment of cirrhosis and refractory ascites.Methods A total of 60 patients with cirrhosis and refractory ascites hospitalized in our hospital from January 2016 to December 2017 were selected as the study subjects,and they were randomly divided into the control group(30 cases)and the observation group(30 cases).The control group received routine treatment measures such as liver protection,enzyme lowering,diuretic detumescence,protein supplementation and electrolyte balance,and antiviral treatment for viral hepatitis patients.A modified central venous catheter was used for intraperitoneal indwelling drainage.In the observation group,20 mg of Dopamine Hydrochloride and 20-40 mg of Tolasemine were injected into the abdominal cavity at the same time every other day on the basis of the control group.The therapeutic effects of the two groups were compared.Results The total effective rate of the observation group was 90%,which was higher than 50%of the control group,and the difference was statistically significant(P＜0.05).The improvement of liver function indexes in the observation group was better than that in the control group,and the difference was statistically significant(P＜0.05).Conclusion Modified abdominal puncture drainage combined with intraperitoneal injection of Torsemide and Dopamine in the treatment of cirrhosis and refractory ascites can synergistically improve the clinical treatment effect,which can be further promoted and applied.

Key words： Cirrhosis Refractory ascites Intraperitoneal injection Torasemide Dopamine

基金资助:江西省萍乡市医药卫生计生新技术引进项目（2018-4-23）

引用本文:

赖建荣;易培庄;周启明;陈远辉;段小萍. 改良腹腔穿刺置管引流术联合腹腔内注射托拉塞米、多巴胺治疗肝硬化并难治性腹水的临床效果[J]. 中国当代医药, 2018, 25(30): 42-44.
LAI Jian-rong;YI Pei-zhuang;ZHOU Qi-ming;CHEN Yuan-hui;DUAN Xiao-ping. Clinical effect of modified abdominal puncture drainage combined with intraperitoneal injection of Torsemide and Dopamine in the treatment of cirrhosis with refractory ascites. 中国当代医药, 2018, 25(30): 42-44.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2018/V25/I30/42

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