Wilcox C M, Woods B L, Mixon H T
Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.
Am J Gastroenterol. 1992 Oct;87(10):1443-6.
Large volume paracentesis is becoming a popular form of therapy for patients with massive ascites and cirrhosis. Although the physiologic effects of the removal of large amounts of ascitic fluid have been well described, the techniques utilized to perform the procedure are either not well documented or not currently available. Over a 13-month period, 52 patients with moderate to severe ascites have undergone 73 large volume paracenteses with a peritoneal dialysis catheter system. The mean volume of ascitic fluid removed was 7.6 L, with a mean time of removal of 129 min. Total paracentesis was accomplished within 1 h in 38% of procedures. The most common site for paracentesis was the left lower quadrant. Complications related to the procedure were few, the most common being a self-limited ascitic fluid leak at the sight of paracentesis. No patient experienced intestinal perforation, peritonitis, or a significant change in serum creatinine after the procedure. The widely available peritoneal dialysis catheter system represents a safe and rapid technique for the removal of large quantities of ascitic fluid.
大量腹腔穿刺术正成为治疗大量腹水和肝硬化患者的一种常用治疗方式。尽管大量腹水清除的生理效应已得到充分描述，但用于实施该操作的技术要么记录不完善，要么目前无法获取。在13个月的时间里，52例中重度腹水患者使用腹膜透析导管系统进行了73次大量腹腔穿刺术。抽出的腹水平均量为7.6升，平均抽取时间为129分钟。38%的操作在1小时内完成了全部腹腔穿刺。最常用的穿刺部位是左下腹。与该操作相关的并发症很少，最常见的是穿刺部位出现自限性腹水渗漏。术后没有患者出现肠穿孔、腹膜炎或血清肌酐显著变化。广泛使用的腹膜透析导管系统是一种安全、快速的大量腹水清除技术。
