关键词: 前瞻性, 血浆胶体渗透压, 乳糜性积液, 肾功能, 肝硬化失代偿期

Abstract: Objective To investigate the features, diagnosis and treatment of liver cirrhosis complicated with chylothorax and/or chylous ascites. Methods Select 4 patients with liver cirrhosis complicated with chylothorax/ chylous ascites admitted to our hospital from March 2022 to March 2023, collect their characteristics and laboratory data, and give high-dose human albumin combined with somatostatin analog therapy, and observe its curative effect and prognosis. Results (1) The average age of the patients was 61±8.91 years old, and 3/4 were male; 3 cases were caused by hepatitis B virus infection, 1 case was alcohol; 3 cases were complicated with renal insufficiency, 2 cases had hypoproteinemia; 2 cases The Child-Pugh classification was grade C, 1 case was complicated with hepatorenal syndrome, and the MELD score was greater than 20; (2) 3 cases had chylomicron appearance, and 1 case was light yellow; 3 cases were positive for chylomicrons, and 3 cases were present at the same time chylothorax and ascites effusion, 1 case of pleural effusion, 1 case of chylous ascites; (3) After administration of large doses of human serum albumin, the effusions of four patients all subsided compared with before, and the serum creatinine improved. Patients were followed up at 1 month, 3 months, and 6 months after discharge; three patients were in stable condition, and one patient died after four months of follow-up. Conclusion The treatment of patients with chylothorax/ chylous ascites with high-dose albumin combined with somatostatin analogues can help the effusion subside, improve the renal function and even the quality of life of the patients.

Key words: Prospective, Plasma colloid osmolality pressure, Celiac effusion, Renal function, Cirrhotic decompensation stage