CAJ | 학술논문

目的：探讨生长激素(GH)对肝功能ChildC级门脉高压症合并上消化道大出血内科治疗无效而被迫行断流术后出现的顽固性低蛋白血症和难控性腹水的治疗价值。方法：20例病人随机分为三组：A组为，肠外营养(PN)8天；B组为PN+GH,PN同A组，应用重组人GH(rhGH)8U,1次/d，7天；C组为单纯rhGH组，rhGH应用方法同B组。术后动态观察血浆蛋白、腹水、病死率和其他一般情况。结果：PN+rhGH术后1周起白浆蛋白水平高于其他两组，腹水消退快，一般情况好，无死亡病例。结论：肝功能ChildC级门脉高压合并上消化道大出血内科治疗无效，急诊断流术后应用PN加生长激素对纠正顽固性低蛋白血症、控制术后腹水的增长有良好的疗效，作用较持久，可减少术后病死率，改善病人生活质量，但一定要给予静脉营养支持以提供必要的蛋白合成底物和能量。同时临床经验告诉我们，rhGH的应用一定要足量、足疗程
목적：탐토생장격소(GH)대간공능ChildC급문맥고압증합병상소화도대출혈내과치료무효이피박행단류술후출현적완고성저단백혈증화난공성복수적치료개치。 방법：20례병인수궤분위삼조：A조위，장외영양(PN)8천；B조위PN+GH,PN동A조，응용중조인GH(rhGH)8U,1차/d，7천；C조위단순rhGH조，rhGH응용방법동B조。술후동태관찰혈장단백、복수、병사솔화기타일반정황。 결과：PN+rhGH술후1주기백장단백수평고우기타량조，복수소퇴쾌，일반정황호，무사망병례。 결론：간공능ChildC급문맥고압합병상소화도대출혈내과치료무효，급진단류술후응용PN가생장격소대규정완고성저단백혈증、공제술후복수적증장유량호적료효，작용교지구，가감소술후병사솔，개선병인생활질량，단일정요급여정맥영양지지이제공필요적단백합성저물화능량。동시림상경험고소아문，rhGH적응용일정요족량、족료정
Objectives:To study the effects of recombinant human growthhormone(rhGH) in treatment of portal hypertension patients with hypoproteinemia and intractable ascites. Methods:20 cases of patients with portal hypertention (Child's Class C) with bleeding were randomly divided into 3 groups and rhGH was used to treat hypoproteinemia and intractable ascites only or with parenteral nutrition in the postoperative period. Results:The hypoproteinia and ascites were alleviated,the incidence rate of postoperative complications and mortality were reduced,and the life quality of the patients was improved in patients in whom rhGH had been used,especially when used simultaneously with parenteral nutrition. Conclusions:The postoperative use of rhGH is beneficial to alleviate the hypoproteinemia and ascites in patients with portal hypertention,especially when combined with the use of parenteral nutrition.