托伐普坦联合腹水超滤浓缩回输术治疗肝硬化并发顽固性腹水患者疗效初步研究*

doi:10.3969/j.issn.1672-5069.2023.03.024

Abstract

Abstract: Objective The aim of this study was to investigate the clinical efficacy of tolvaptan and concentrated ascites reinfusion (CAR) in the treatment of patients with liver cirrhosis-induced refractory ascites (RA). Methods 93 patients with liver cirrhosis-induced RA were encountered in our hospital between September 2019 and September 2022, and were randomly divided into control (n=46) and observation group (n=47), receiving CAR or oral tolvaptan after CAR. The observation lasted for 7 days. Blood urea nitrogen (BUN), serum creatinine (sCr) and serum sodium levels were detected by fully automatic biochemical analyzer. The diameter of portal vein (DPV), diameter of splenic vein (DSV), portal vein flow (PVF) and splenic vein flow (SVF) were measured by ultrasonography. Results At treatment day 7, the 24-hour urine volume in the observation group was (1957.5±50.3) mL, significantly greater than [(1316.2±49.1) mL, P<0.05] in the control group, and the body weight, abdominal circumference and ascites depth were (58.1±7.2)kg, (80.6±4.7)cm and (16.5±4.2)mm, all significantly less than [(65.4±7.8)kg, (88.1±4.5)cm and (42.7±5.3)mm, respectively, P<0.05] in the control; serum BUN and sCr levels in the observation group were (6.2±1.4)mmol/L and (114.2±9.7)μmol/L, much lower than [(6.9±1.6)mmol/L and (129.4±10.3)μmol/L, P<0.05] in the control, while there were no significant differences respect to liver function tests between the two groups (P>0.05); serum sodium level was (144.3±1.1)mmol/L, much higher than [(138.1±1.0)mmol/L, P<0.05] in the control; the PVF was (994.3±195.7)mL/min, much lower than [(1175.2±210.6) mL/min, P<0.05] in the control, while there were no significant differences respect to DPV, DSV and SVF between the two groups (P>0.05). Conclusion The oral administered tolvaptan at base of CAR in dealing with patients with liver cirrhosis-induced RA could help subside ascites, improve the renal function tests and serum sodium levels, and warrants further clinical observation.

Key words: Liver cirrhosis, Refractory ascites, Tolvaptan, Concentrated ascites reinfusion, Therapy

Liu Kun, Xu Jing, Ma Zhufang. Transient improvement of patients with liver cirrhosis-induced refractory ascites by oral tolvaptan administration at base of concentrated ascites reinfusion[J]. Journal of Practical Hepatology, 2023, 26(3): 396-399.

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Transient improvement of patients with liver cirrhosis-induced refractory ascites by oral tolvaptan administration at base of concentrated ascites reinfusion

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