目的 探讨肝硬化并发肝性胸水的临床特点、发生机制及治疗。 方法 回顾分析2006年3月-2009年3月收治的49例肝硬化并发肝性胸水患者的临床资料。 结果 肝性胸水的发生率为18.9%，多见于右侧（71.4%）。胸水性质多为漏出液（81.6%），但渗出液亦不少见（18.4%）。门脉高压和低蛋白血症是肝性胸水发生的重要原因。 结论 临床上肝硬化并发胸水并不少见，应高度重视，采取多种综合治疗方法可提高疗效。
ObjectiveTo explore the safety and feasibility of contrast enhanced intraoperative ultrasonographyguided percutaneous radiofrequency ablation with artificial hydrothorax to hepatocellular carcinoma in the hepatic dome. MethodsThe clinical data of nine patients with hepatocellular carcinoma in the hepatic dome underwent ultrasonographyguided percutaneous radiofrequnecy ablation with artificial hydrothorax from January 2008 to June 2009 at Department of Hepatobiliopancreatic Surgery of West China Hospital were retrospectively analyzed. The perioperative results and recurrence of tumor were also analyzed. ResultsAll of nine patients with twelve tumors received successfully radiofrequency ablation with artificial hydrothorax of (2 444±464) ml (2 000-3 000 ml). The ablation time was 12-24 min (median 12 min), with an average of (15±5) min for each tumor. No hemothorax, pneumothorax, and death occurred during operation. One patient had ascites of 2 000 ml after ablation due to hypoalbuminenia, and ascites disappeared by infusion of abumin on 4 d after operation. The total volume of pleural drainage was 250-1 420 ml, with an average of (717±372) ml for each patient, and the drainage tube was withdrawn on 3-5 d after operation. The followup time was 7-23 months (mean 15 months). Tumor recurrence was found in three patients on 5, 6, and 7 months after operation, respectively. Of them, two patients were in stable disease stage after interventional and conservative therapy, respectively, and one case recurred at six months after operation and died of hypertensive heart disease and hepatic function deterioration at sixteen months after operation. The rest patients survived and no recurrence and metastasis was observed during the follow-up period.ConclusionThe technique of percutaneous radiofrequency ablation with artificial hydrothorax increases the feasibility of the minimal invasive treatment for hepatoma, which can be applied to hepatocellular carcinoma in the hepatic dome with high safety and clinical application value.
ObjectiveTo determinate the concentration of isonicotinyl hydrazide (INH) in the hydrothorax and thereby increase the drug concentration of the hydrothorax to enhance the anti-tuberculosis efficacy through experiments. MethodsBetween February and June 2009, we used high performance liquid chromatography (HPLC) to determinate the concentration of INH in the hydrothorax of tuberculosis (TB) patients. The separation of sample was performed on Agilent ZORBAX SB-C18 (5 μm, 4.6 mm×2.5 mm) column with a fixed sample injection volume of 20 μL. The mobile phase was methanol-water (20︰80) at a flow rate of 1 mL/min. The ultraviolet detective wavelength was set at 254 nm; The column temperature was room temperature. ResultsIn the range of 0.25-10.00 μg/mL (r=0.998 9), moxi-floxacin showed a good linear relation in HPLC. The recoveries of moxi-floxacin at three concentrations (0.5, 5.0, and 10.0 μg/mL) were 97.95%, 100.64%, and 102.84%, respectively, with intra-day relative standard deviation (RSD) at 3.49%, 1.45%, and 2.03%, respectively and intra-day RSD at 3.85%, 5.68%, 4.15%, respectively. ConclusionThe measuring method adopted in the experiment can accurately determinate the concentration of INH in the hydrothorax with high sensitivity and exceptional reproducibility.