Lai K N, Pun C O, Leung J W
Department of Medicine, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories.
J Gastroenterol Hepatol. 1989 Jul-Aug;4(4):325-30. doi: 10.1111/j.1440-1746.1989.tb00843.x.
Three cirrhotic patients with intractable ascites and one patient with malignant ascites received dialytic ultrafiltration of ascitic fluid by a haemofilter system for symptomatic relief. The haemofilter removes fluid and substances with a molecular weight less than 50,000 daltons and the concentrated ascitic fluid was reinfused into the peritoneal cavity after ultrafiltration. The changes in intraperitoneal and hepatic venous wedge pressures were studied in these patients. Dialytic ultrafiltration of ascites was associated with a parallel fall of both intraperitoneal and hepatic venous wedge pressures in cirrhotic patients but not in the patient with malignant ascites. The intraperitoneal and hepatic venous wedge pressure remained low for 18 h after completion of dialytic ultrafiltration. The mean arterial pressure and central venous pressure remained unchanged despite rapid removal of ascitic fluid. The interrelationships between the intraperitoneal pressure, hepatic venous wedge pressure, and vascular volume are discussed.
三名患有顽固性腹水的肝硬化患者和一名患有恶性腹水的患者接受了通过血液滤过系统进行的腹水透析超滤以缓解症状。血液滤过器可去除液体和分子量小于50,000道尔顿的物质，浓缩的腹水在超滤后重新注入腹腔。对这些患者的腹腔内压力和肝静脉楔压变化进行了研究。肝硬化患者的腹水透析超滤与腹腔内压力和肝静脉楔压的平行下降有关，但恶性腹水患者则不然。透析超滤完成后，腹腔内压力和肝静脉楔压在18小时内保持较低水平。尽管腹水被快速清除，但平均动脉压和中心静脉压保持不变。讨论了腹腔内压力、肝静脉楔压和血容量之间的相互关系。
