Prognosis assessment of cirrhotic patients with refractory ascites treated with a peritoneovenous shunt.
Prognosis assessment of cirrhotic patients with refractory ascites treated with a peritoneovenous shunt.
复制标题
腹膜静脉分流术治疗难治性腹水的肝硬化患者的预后评估。
DOI：
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发表时间：
1995
影响因子：
9.8
通讯作者：
L. Casais
中科院分区：
文献类型：
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作者：
J. Guardiola;X. Xiol;Escribá Jm;J. Castellví;J. Castellote;C. Baliellas;A. Rafecas;L. Casais
客观化
腹膜静脉分流术在顽固性腹水治疗中的作用尚未明确。这项研究的目的是确定在接受腹膜静脉分流术治疗的顽固性腹水患者中容易获得的预测生存因素。
方法
我们研究了在一所大学的参考医院接受腹膜静脉分流术的100名患有顽固性腹水的肝硬变患者的队列。
结果
分流术后患者的中位生存期为11个月(95%可信区间，7-14个月)。基于比例风险模型的多变量分析揭示了与生存不良相关的四个独立变量：高Pugh评分、非酒精病因、低腹水蛋白浓度和自发性细菌性腹膜炎病史。
结论
采用腹膜静脉分流术治疗的肝硬变患者的死亡率可以通过使用四个容易获得的变量的预后指数来确定。这样的预后指数，一旦被前瞻性验证，可以作为计划治疗肝硬变顽固性腹水患者的辅助手段。
OBJECTIVE
The role of peritoneovenous shunt in the management of refractory ascites has not been clearly established. The aim of this study was to determine readily accessible predictive survival factors in cirrhotic patients with refractory ascites treated with a peritoneovenous shunt.
METHODS
We studied a cohort of 100 cirrhotic patients with refractory ascites who underwent peritoneovenous-shunt placement in a university-based reference hospital.
RESULTS
The estimated median survival of patients after shunt placement was 11 months (95% CI, 7-14 months). Multivariate analysis based on the proportional hazards model disclosed four independent variables associated with poor survival: high Pugh score, nonalcoholic etiology, low ascitic fluid protein concentration, and history of spontaneous bacterial peritonitis.
CONCLUSIONS
Mortality of cirrhotic patients treated with a peritoneovenous shunt can be determined by a prognostic index using four easily available variables. Such a prognostic index, once prospectively validated, could be used as an adjunct in planning treatment of cirrhotic patients with refractory ascites.