Objective To explore the methods and effect of venous retransfusion of ascites on the treatment of the complicated patients with Budd-Chiari syndrome.Methods Eighteen complicated and (or) recrudescent patients with Budd-Chiari syndrome were treated by venous retransfusion of ascites between March 2006 and July 2009. The changes in abdominal girth, body weight, the urine volume of 24 h, liver function, renal function, and serum electrolyte measurements before and after treatment were compared. Results After retransfusion of 5 000 ml to 7 800 ml (mean 6 940 ml) ascites, the abdominal girth of patients decreased (Plt;0.05), the urine volume of 24 h tended to normal and during which no serious side-effect happened. The levels of serum BUN, CREA, prothrombin time (PT), and activated partial thromboplastin time (APTT) decreased significantly (Plt;0.05), furthermore the levels of total albumen and albumin increased significantly (Plt;0.05). The changes of serum electrolyte measurements were not significant (Pgt;0.05). The follow-up period for all the patients was in the range of 4 to 37 months (mean 19 months). Then 12 patients were treated by the second operation at 3-6 months after discharge. Conclusions The ascites retransfusion provides a safe and effective treatment option for patients with refractory ascites, and yields a higher likelihood of discharge compared with conventional paracentesis. It is useful in improving quality of life and winning the operational chance for such as patients with complicated Budd-Chiari syndrome.
【Abstract】Objective To investigate the protective effects of epidermal growth factor (EGF) on pancreas of rats with acute pancreatitis(AP). Methods Seventytwo male SpragueDawley rats were randomly divided into 3 groups: Control group, AP group and AP-EGF group. Subcutaneously injection of EGF (0.1 μg/g) were given to animals in the AP-EGF group after the establishment of the model of AP. The other two groups of animals received the same volume of saline. At 6 h, 12 h and 24 h after induction of AP, 8 animals in each group were sacrificed respectively， 4 ml of blood sample was withdrawn from heart，2 ml for the analysis of amylase activity and 2 ml for MDA content in serum. Ascites was sucked with dry gauzes and was weighed thereafter. Changes of pancreas morphology were evaluated at every time point. The same part of pancreas was removed for measurement of MDA content, apoptotic index (AI) and histologic changes. Results Histologic injury of the animals in the APEGF group was milder than that in the AP group. Ascites weight in the AP-EGF group decreased significantly compared with that in the AP group at 12 h and 24 h 〔(4.53±1.29) g vs (6.58±1.47) g, (7.64±1.85) g vs (11.96±2.13) g，P＜0.05，P＜0.01〕. Amylase activity in the APEGF group also decreased significantly compared with that in the AP group at 12 h and 24 h 〔(142.0±8.3) U/L vs (187.9±10.4) U/L, (194.3±10.4) U/L vs (253.3±8.6) U/L, P＜0.05，P＜0.01〕. MDA content in plasm 〔(2.34±0.23) μmol/L vs (3.15±0.38) μmol/L, P＜0.05〕 and in pancreas 〔(5.21±1.46) μmol/g vs (7.68±1.63) μmol/g, P＜0.01〕 in the APEGF group decreased significantly compared with those in the AP group at 24 h. AI of pancreas in the APEGF group increased significantly compared withthatintheAPgroupafteroperation〔(16.22±3.53)%〖KG4vs (7.35±1.04)%, (11.67±2.40)% vs (4.81±0.86)%, (6.38±1.42)% vs (1.97±0.21)%, P＜0.01〕. Conclusion EGF may accelerate the restoration of pathologic injury and alleviate the hemorrhage and edema of pancreas. It may also depress MDA content in plasm and in pancreas so that to lessen oxidative damage. EGF may protect pancreas by inducing cellular apoptosis.
Objective To investigate the efficacy and safety of abdominal indwelling catheterization for the patients with large-volume ascites. Methods A total of 84 patients with liver cirrhosis complicated with large-volume ascites admitted in the first affiliated hospital of Xi’an Jiaotong University from January 2015 to December 2015 were retrospectively analyzed. Patients were divided into two groups, one was the puncture group and another was the catheterization group. The efficacy and safety were evaluated. Results Forty-four patients were enrolled in catheterization group, whereas forty patients were enrolled in puncture group. Symptoms associated with ascites had been eased and patients’ qualities of life had been improved in 2 weeks in each group. The tube fell out rate was 27.3% for patients in catheterization group. There was no operation related complications such as death, bleeding and intestinal perforation occurred. Either Child B stage or Child C stage, the dynamic changes of liver function and renal function in catheterization group were comparable to those in puncture group. No adverse event such as catheterization-related or puncture-related infection was observed. Conclusion Abdominal catheterization is effective and safe in management of large amount of ascites complicated with cirrhosis, however, the high rate of tube-fell-out should be paid more attention.