심한 복수를 동반한 간경변 환자에서 대량 복수천자시 사용되는 혈장증량제로서 Albumin과 Hydroxyethyl Starch 효과의 비교 ( The Efficacy of Hydroxyethyl Starch as Plasma Expander in Cirrhotic Patients with Tense Ascites Treated with Large Volume Paracentesis )
분야
의약학 > 내과학
저자
장린(Rin Chang),장영운(Young Woon Chang),이정일(Joung Il Lee),김병호(Byoung Ho Kim),김효종(Hyo Jong Kim),동석호(Seok Ho Dong),강경의(Kyung Eui Kang)
발행기관
대한소화기학회
간행물정보
대한소화기학회지 1998년, 제31권 제5호, 651~660쪽(총10쪽)
파일형식
07803956.pdf [무료 PDF 뷰어 다운로드]
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    영문초록
    Background/Aims: Albumin is widely used as plasma expander to prevent circulatory dysfunction developed after large volume paracentesis (LVP) in cirrhotics with tense ascites. Considering the high cost of albumin, we decided to investigate prospectively whether hydroxyethyl stareh (HES) can prevent circulatory and renal dysfunction after paracentesis. Methods: Twelve cirrhotics with tense ascites were randomly assigned to receive albumin (group I, n=6) or HES (group II, n=6). Salt and fluid were restricted and diuretics were withdrawn at least for two days. Then, LVP was performed and followed by slow infusion of plasma expander, 8 g/L ascites. Circulatory and renal dysfunction were monitored before, one and two days after LVP. Results: Clinical characteristics, liver function and etiologies of cirrhosis in both groups were not different. The average amount of ascites removed from hoth groups was 4.3+-0.98 L and 4.4+-0.55 L, respectively. After LVP, hepatic encephalopathy, hemodynamic and renal dysfunction were not developed and the vital signs were not changed in any patients. Compared with the basal level, the amount of urine output increased immediately and two days after LVP in all patients of group I (592+-80 -> 816+-392 -> 1166+-671 mL/day) and in group II (441+-211 -> 683+-354 -> 667+-280 mL/day). No patients died of LVP cornplications during the admission. Conclusioes: These results suggest that HES is as effective and safe as albumin to prevent hemodynamic and renal dysfunction complicated by LVP in cirrhotics with tense ascites , and may be an alternative to albumin, the expensive plasma expander.(KoreanGaetroeeterol1998;31:631-660)
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