Salerno F, Badalamenti S, Incerti P, Moser P, Capozza L, Lorenzano E, Restelli B
Istituto di Medicina Interna, Università di Milano, Italy.
Ital J Gastroenterol. 1990 Feb;22(1):44-9.
Paracentesis is the oldest method for treating patients with ascites, but the fear of serious side-effects and the coincident introduction of effective non-toxic diuretic drugs led to its abandonment during the fifties. In recent years, several studies have investigated whether abdominal evacuation of ascitic fluid is truly dangerous for cirrhotic patients. The results of some randomized controlled trials comparing paracentesis with a traditional diuretic therapy showed that the rate of complications after paracentesis, particularly when the procedure was combined with a sufficient plasma expansion, was equal to or lower than that of diuretic treatment. Moreover, the ability of paracentesis to resolve tense ascites, both in terms of number of successes and of time required to obtain ascites resolution, was similar or even higher. These data and the recent new interest of several investigators in employing ascitic fluid examination for diagnostic purposes have increased the use of this procedure in the clinical practice.
腹腔穿刺术是治疗腹水患者最古老的方法，但由于担心严重的副作用以及同时出现了有效的无毒利尿剂，导致该方法在五十年代被弃用。近年来，多项研究探讨了对肝硬化患者进行腹腔排液是否真的危险。一些将腹腔穿刺术与传统利尿疗法进行比较的随机对照试验结果表明，腹腔穿刺术后的并发症发生率，尤其是在该操作与充分的血浆扩容相结合时，等于或低于利尿治疗的并发症发生率。此外，腹腔穿刺术在解决张力性腹水方面，无论是成功的次数还是腹水消退所需的时间，都相似甚至更高。这些数据以及最近一些研究人员对将腹水检查用于诊断目的的新兴趣，增加了该操作在临床实践中的应用。
