Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada K1Y 4E9.
Department of Epidemiology and Community Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada K1Y 4E9.
Can J Gastroenterol Hepatol. 2016;2016:4680543. doi: 10.1155/2016/4680543. Epub 2016 Jun 5.
Background. Treatment options are limited for patients with refractory cirrhotic ascites (RCA). As such, we assessed the safety and effectiveness of the PleurX catheter for RCA. Methods. A retrospective analysis was performed on all patients with RCA who have undergone insertion of the PleurX catheter between 2007 and 2014 at our clinic. Results. Thirty-three patients with RCA were included in the study; 4 patients were lost to follow-up. All patients were still symptomatic despite bimonthly large volume paracentesis and were not candidates for TIPS or PV shunt. Technical success was achieved in 100% of patients. The median duration the catheter remained in situ was 117.5 days, with 95% CI of 48-182 days. Drain patency was maintained in 90% of patients. Microorganisms consistent with spontaneous bacterial peritonitis (SBP) from a catheter source were isolated in 38% of patients. The median time to infection was 105 days, with 95% CI of 34-233 days. All patients were treated for SBP successfully with antibiotics. Conclusion. Use of the PleurX catheter for the management of RCA carries a high risk for infection when the catheter remains in situ for more than 3 months but has an excellent patency rate and did not result in significant renal injury.
对于难治性肝硬化腹水（RCA）患者，治疗选择有限。因此，我们评估了 PleurX 导管治疗 RCA 的安全性和有效性。
对 2007 年至 2014 年在我院接受 PleurX 导管插入术的所有 RCA 患者进行回顾性分析。
研究纳入 33 例 RCA 患者，4 例失访。尽管每月进行两次大容量腹腔穿刺术，但所有患者仍有症状，不适合 TIPS 或 PV 分流。所有患者均获得技术成功。导管在位的中位时间为 117.5 天，95%CI 为 48-182 天。90%的患者保持引流通畅。38%的患者从导管来源分离出与自发性细菌性腹膜炎（SBP）一致的微生物。感染的中位时间为 105 天，95%CI 为 34-233 天。所有患者均成功接受抗生素治疗 SBP。
当导管在位超过 3 个月时，PleurX 导管用于 RCA 管理的感染风险很高，但具有极好的通畅率，且不会导致明显的肾损伤。
