Shao J, Zhang L, Han G H, Fan D M
Department of Liver Disease and Digestive Interventional Radiology, Xijing Hospital of the Fourth Military Medical University, Xi'an 710032, China.
Zhonghua Gan Zang Bing Za Zhi. 2016 Oct 20;24(10):721-723. doi: 10.3760/cma.j.issn.1007-3418.2016.10.001.
Ascites is a common clinical manifestation of cirrhotic portal hypertension, and about 60%-80% of cirrhotic patients develop the symptom of ascites within 10 years. Once ascites occurs, the 5-year survival rate is reduced from 80% to 50%. With the progression of liver diseases, approximately 5%-10% of patients with ascites develop refractory ascites, and the median survival time is only 6-12 months. This article reviews the definition and diagnosis of refractory ascites, evaluation of prognostic factors, and treatment regimens, including large-volume paracentesis combined with protein supplementation, transjugular intrahepatic portosystemic shunt, and liver transplantation.
腹水是肝硬化门静脉高压的常见临床表现，约60%-80%的肝硬化患者在10年内会出现腹水症状。一旦出现腹水，5年生存率会从80%降至50%。随着肝脏疾病的进展，约5%-10%的腹水患者会发展为难治性腹水，中位生存时间仅为6-12个月。本文综述了难治性腹水的定义与诊断、预后因素评估以及治疗方案，包括大量腹腔穿刺放液联合补充蛋白、经颈静脉肝内门体分流术和肝移植。
