Sakai Hideki, Sheer Todd A, Mendler Michel H, Runyon Bruce A
Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Kashiwa City Hospital, Kashiwa, Chiba, Japan.
Liver Int. 2005 Oct;25(5):984-6. doi: 10.1111/j.1478-3231.2005.01149.x.
The optimal location for paracentesis has not been studied scientifically. The evolving obesity epidemic has changed the physique of many patients with cirrhosis and ascites such that needles inserted into the abdominal wall may not reach fluid. We aimed to determine the location for paracentesis that would have the thinnest abdominal wall and the deepest amount of fluid.
Ultrasound measurements of abdominal wall thickness and depth of ascites were recorded in two locations, the infraumbilical midline (ML) and the left lower quadrant (LLQ), in 52 patients with cirrhosis and ascites admitted to a single inpatient liver unit.
The abdominal wall was significantly thinner (1.8 vs. 2.4 cm; P<0.001) and the depth of ascites greater (2.86 vs. 2.29 cm; P=0.017) in the LLQ as compared with the infraumbilical ML position. In the left lateral oblique position, the difference in the depth of ascites was more pronounced when comparing the LLQ with the infraumbilical ML (4.57 vs. 2.78 cm; P<0.0001).
The LLQ is preferable to the ML infraumbilical location for performing paracentesis.
腹腔穿刺术的最佳位置尚未经过科学研究。不断演变的肥胖流行趋势改变了许多肝硬化腹水患者的体型，以至于插入腹壁的穿刺针可能无法触及腹水。我们旨在确定腹壁最薄且腹水最深的腹腔穿刺位置。
对入住单一住院肝病单元的52例肝硬化腹水患者，在脐下中线（ML）和左下腹（LLQ）两个位置记录腹壁厚度和腹水深度的超声测量值。
与脐下ML位置相比，LLQ处的腹壁明显更薄（1.8对2.4厘米；P<0.001），腹水深度更大（2.86对2.29厘米；P=0.017）。在左侧斜位时，比较LLQ和脐下ML，腹水深度差异更明显（4.57对2.78厘米；P<0.0001）。
进行腹腔穿刺术时，LLQ优于脐下ML位置。
