Shaikh Mumtaz Ali, Khan Jehangir, Almani Suhail, Shaikh Dargahi
Department of Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan.
J Ayub Med Coll Abbottabad. 2010 Apr-Jun;22(2):88-92.
Ascites can be defined as accumulation of free fluid in the peritoneal cavity. It is the most common complication of cirrhosis and is associated with a poor quality of health, increased risks of infections, renal failure and a poor long-term outcome. This descriptive analytical study was conducted on one hundred and fifty diagnosed patients of ascites consecutively admitted in medical unit of tertiary care facility attached to Muhammad Medical College, Mirpur Khas, Sindh, from Oct 2006 to Sep 2008.
Special proforma was prepared containing patients' basic information, history, clinical findings and investigations necessary to diagnose the cause of ascites. Patients with ascites due to perforation and intraperitoneal bleeding were excluded from the study. Serum-ascitic albumin gradient (SAAG) was calculated and patients were grouped into high and low SAAG groups. The obtained data was analysed using SPSS- 11.
In this study 150 patients of ascites were included. Patients were arranged in two groups. High SAAG 'high portal pressure' group and low SAAG 'low portal pressure' group. In high SAAG group patients included were 128 (85.33%), and in low SAAG group patients included were 22 (14.66%). In high SAAG group, out of 128 (85.33%) patients 122 (81.33%) were of cirrhotic ascites, [(viral hepatitis B, C and combined 105 (70%), alcoholic 7 (4.66%), cryptogenic 10 (6.66%)], heart failure ascitic patients were 5 (3.33%), and constrictive pericarditis 1 (0.66). In low SAAG group out of 22 (14.66%) patients malignant ascites was (primary peritoneal carcinomatosis and metastasis) 11 (7.33%), tuberculous ascites was 10 (6.66%), and ascites due to nephrotic syndrome was 1 (0.66%).
As large number of cases of ascites are due to cirrhosis of liver that has little or no cure in developing countries. Media and NGO's should further work to increase awareness of this deadly problem.
腹水可定义为腹腔内游离液体的积聚。它是肝硬化最常见的并发症，与健康状况不佳、感染风险增加、肾衰竭及不良的长期预后相关。本描述性分析研究于2006年10月至2008年9月对在信德省米尔布尔哈斯市穆罕默德医学院附属三级医疗机构内科连续收治的150例确诊腹水患者进行。
准备了包含患者基本信息、病史、临床检查结果及诊断腹水病因所需检查的专用表格。因穿孔和腹腔内出血导致腹水的患者被排除在研究之外。计算血清腹水白蛋白梯度（SAAG），并将患者分为高SAAG组和低SAAG组。使用SPSS - 11对获得的数据进行分析。
本研究纳入了150例腹水患者。患者被分为两组。高SAAG“高门静脉压”组和低SAAG“低门静脉压”组。高SAAG组纳入患者128例（85.33%），低SAAG组纳入患者22例（14.66%）。在高SAAG组的128例（85.33%）患者中，122例（81.33%）为肝硬化腹水，[（乙型、丙型病毒性肝炎及合并感染105例（70%），酒精性7例（4.66%），隐源性10例（6.66%）]，心力衰竭性腹水患者5例（3.33%），缩窄性心包炎1例（0.66%）。在低SAAG组的22例（14.66%）患者中，恶性腹水（原发性腹膜癌和转移癌）11例（7.33%），结核性腹水10例（6.66%），肾病综合征所致腹水1例（0.66%）。
由于在发展中国家大量腹水病例是由肝硬化引起，而肝硬化几乎无法治愈。媒体和非政府组织应进一步努力提高对这一致命问题的认识。
