De Gottardi Andrea, Thévenot Thierry, Spahr Laurent, Morard Isabelle, Bresson-Hadni Solange, Torres Ferran, Giostra Emiliano, Hadengue Antoine
Division of Gastroenterology and Hepatology, University Hospital of Geneva, Geneva, Switzerland.
Clin Gastroenterol Hepatol. 2009 Aug;7(8):906-9. doi: 10.1016/j.cgh.2009.05.004. Epub 2009 May 15.
BACKGROUND & AIMS: Complications and technical problems of paracentesis in cirrhotic patients are infrequent. However, the severity and the incidence of these events and their risk factors have not been assessed prospectively.
Cirrhotic patients (n = 171) undergoing paracentesis were included. Of the 515 paracenteses, 8.8% were diagnostic, and 91.2% were therapeutic. Technical features, demographic data, and adverse events during a period of 72 hours after the procedure were examined.
Major complications occurred in 1.6% of procedures and included 5 bleedings and 3 infections, resulting in death in 2 cases. Major complications were associated with therapeutic but not diagnostic procedures and tended to be more prevalent in patients with low platelet count (<50 10(9)/L), Child-Pugh stage C, and in alcoholic cirrhosis patients. Technical problems occurred in 5.6%. The most frequent complication was a leak of ascites at the puncture site (5.0%), and in 89.5% there were no complications.
The safety of paracentesis in cirrhotic patients might be decreased if risk factors, which depend on the characteristics of the patient and of the procedure itself, are present.
肝硬化患者腹腔穿刺术的并发症及技术问题并不常见。然而，这些事件的严重程度、发生率及其危险因素尚未得到前瞻性评估。
纳入接受腹腔穿刺术的肝硬化患者（n = 171）。在515次腹腔穿刺术中，8.8%为诊断性穿刺，91.2%为治疗性穿刺。对术后72小时内的技术特点、人口统计学数据及不良事件进行检查。
1.6%的穿刺术出现严重并发症，包括5例出血和3例感染，2例死亡。严重并发症与治疗性而非诊断性穿刺相关，在血小板计数低（<50×10⁹/L）、Child-Pugh C级的患者以及酒精性肝硬化患者中更为常见。技术问题发生率为5.6%。最常见的并发症是穿刺部位腹水渗漏（5.0%），89.5%的穿刺术无并发症发生。
如果存在取决于患者特征及穿刺术本身特点的危险因素，肝硬化患者腹腔穿刺术的安全性可能会降低。
