Abstract：Objective: To investigate the efficacy of abdominal indwelling central venous catheter in the treatment of refractory ascites, and to analyze the influencing factors of tube falling. Methods: A total of 96 cirrhotic with refractory ascites patients who received abdominal indwelling central venous catheter drainage ascites from January 2015 to January 2019 were retrospectively analyzed. The efficacy of central venous catheter in the treatment of refractory ascites were evaluated. Then, the patients were divided into a tube falling group and non- tube falling group, and influencing factors about tube fell out were analyzed. Results: The total effective rate of abdominal distension after indwelling central venous catheter was 90.63%. There were no significant differences in white blood cells, platelets, alanine aminotransferase, aspartate aminotransferase , total bilirubin, indirect bilirubin, creatinine, prothrombin time, and procalcitonin before and after tube placement (P>0.05). Albumin was higher than that before tube placement (P<0.05). The incidence of adverse events was 22.92%. Multivariate logistic regression analysis found that the catheter suture fixation as a protective factor for tube falling(OR=0.336).Ascites extravasation (OR=3.961), ascites volume (OR=1.732), catheter indwelling time (OR=3.219) were the risk factors of tube falling. Conclusion: Abdominal indwelling central venous catheter can effectively relieve the symptoms of abdominal distension in patients with refractory ascites due to cirrhosis, and does not affect the blood routine, liver and kidney function, and blood coagulation function. Catheter suture fixation, ascites extravasation, ascites volume, catheter indwelling time are influencing factors of tube fell out.
步光奎, 廖江涛. 腹腔置管引流治疗肝硬化顽固性腹水的效果及脱管的影响因素分析[J]. 河北医学, 2021, 27(9): 1522-1525.
BU Guangkui, LIAO Jiangtao. The Effect of Abdominal Catheterization in the Treatment of Refractory Ascites and Analysis of Influencing Factors of Tube Falling. HeBei Med, 2021, 27(9): 1522-1525.
[1] Krag A,Bendtsen F,Henriksen JH,et al.Low cardiac output predicts development of hepatorenal syndrome and survival in patients with cirrhosis and ascites[J].Gut,2010,59(1):105~110. [2] European association for the study of the liver.EASL clinical practice guidelines for the management of patients with decompensated cirrhosis[J].Hepatol,2018,69(2):406~460. [3] Gaetano JN,Micic D,Aronsohn A,et al.The benefit of paracentesis on hospitalized adults with cirrhosis and ascites[J].Gastroenterol Hepatol,2016,31(5):1025~1030. [4] 周辉,杨淑娟,朱丽,等.腹腔置管引流治疗肝硬化大量腹水有效性和安全性的研究[J].中国循证医学杂志,2017,17(10):1140~1144. [5] Ratre BK,Suvvari P,Hoda W,et al.Central venous catheter as peritoneal indwelling catheter for the management of recurrent malignant ascites:a case series[J].Indian Palliat Care,2019,25(1):57~60. [6] 邵晶,张磊,韩国宏,等.肝硬化顽固性腹水的治疗现状[J].中华肝脏病杂志,2016,24(10):721~723. [7] Agah S,Tavakoli S,Nikbakht H,et al.Central venous pressure catheter for large-volume paracentesis in refractory ascites[J].Indian Gastroenterol,2014,33(4):310~315. [8] Martin DK,Walayat S,Jinma R,et al.Large-volume paracentesis with indwelling peritoneal catheter and albumin infusion:a community hospital study[J].Community Hosp Intern Med Perspect,2016,6(5):32421. [9] Solbach P,Honer Zu Siederdissen C,Taubert R,et al.Home-based drainage of refractory ascites by a permanent-tunneled peritoneal catheter can safely replace large-volume paracentesis[J].Eur Gastroenterol Hepatol,2017,29(5):539~546. [10] Wedd J,Bambha KM,Stotts M,at al.Stage of cirrhosis predicts the risk of liver-related death in patients with low model for end-stage liver disease scores and cirrhosis awaiting liver transplantation[J].Liver Transpl,2014,20(10):1193~1201.
2021, Vol. 27 
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