Russo G E, Caramiello M S, Vitaliano E, Fagiolo M, Pazienza M, Testorio M, Carmenini G, Sagliaschi G
Policlinico Umberto I, Università La Sapienza, Roma.
Riv Eur Sci Med Farmacol. 1994 May-Aug;16(3-4):79-83.
Ascites often appears as a complication of several illnesses. The therapy is essentially based on the use of low-sodium diet, plasma or albumin infusion, diuretics and low-dosed ACE-inhibitors. To use the simple paracentesis or special techniques as Rhodiascit or Lee Veen Shunt means not to resolve definitively the problem and sometimes to cause undesirable complications. The authors present a new therapeutic tactics that joins the use of technique of double filtration of ascitic fluid and reinfusion of concentrated proteins (DFAF) with the injection in the peritoneal cavity of beta-interferon and the venous infusion of ATIII. Twenty patients affected by hepatic cirrhosis with the presence of ascitic fluid not treatable with the usual therapy have been subjected to this treatment. All the patients showed an immediate improvement of the clinical situation. After one year of observation, we describe our results. Twelve patients needed a further treatment with the DFAF technique, two patients died for the original pathology and six patients just needed an adjustment of pharmacologic therapy.
腹水常常作为多种疾病的并发症出现。治疗主要基于低钠饮食、输注血浆或白蛋白、使用利尿剂以及小剂量的血管紧张素转换酶抑制剂。采用单纯腹腔穿刺术或诸如腹水回输装置(Rhodiascit)或李氏分流术(Lee Veen Shunt)等特殊技术,意味着无法彻底解决问题,而且有时还会引发不良并发症。作者提出了一种新的治疗策略,即将腹水双重过滤及浓缩蛋白回输技术(DFAF)与β-干扰素腹腔注射及抗凝血酶III静脉输注相结合。20例患有肝硬化且存在常规治疗无法处理的腹水的患者接受了该治疗。所有患者的临床状况均立即得到改善。经过一年的观察,我们描述了我们的结果。12例患者需要采用DFAF技术进一步治疗,2例患者因原有疾病死亡,6例患者仅需调整药物治疗。