Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2013 Mar;76(3):123-30. doi: 10.1016/j.jcma.2012.11.005. Epub 2013 Jan 23.
Ascites formation in patients with cirrhosis, portal hypertension, or both usually results from hyperdynamic circulatory dysfunction, where the retention of sodium and water is associated with the activation of the sympathetic and renin-angiotensin-aldosterone systems. The presence of ascites indicates the development of liver decompensation. Furthermore, complications seen in conjunction with ascites such as spontaneous bacterial peritonitis, hepatorenal syndrome, and hepatic hydrothorax may result in increased morbidity and mortality. Although nonpharmacological, pharmacological, and surgical approaches have been introduced and clinically practiced, their therapeutic effects are still suboptimal or limited by their potential side effects, such as large-volume paracentesis-induced postparacentesis circulatory dysfunction. Herein, we discuss strategies to prevent and properly manage ascites-related complications, including a review of the literature and controlled studies that assess these strategies.
肝硬化、门静脉高压或两者并存的患者腹水的形成通常是由于高动力循环功能障碍所致，钠和水的潴留与交感神经和肾素-血管紧张素-醛固酮系统的激活有关。腹水的出现表明肝功能失代偿的发生。此外，与腹水相关的并发症，如自发性细菌性腹膜炎、肝肾综合征和肝性胸水，可能导致发病率和死亡率增加。尽管已经引入并在临床上应用了非药物、药物和手术方法，但它们的治疗效果仍然不理想，或者受到其潜在副作用的限制，例如大量腹腔穿刺术引起的腹腔穿刺后循环功能障碍。在此，我们讨论预防和妥善处理腹水相关并发症的策略，包括对这些策略进行评估的文献综述和对照研究。
