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中国肝硬化腹水及其相关并发症管理指南。

Chinese guidelines on the management of ascites and its related complications in cirrhosis.

机构信息

Department of Infectious Diseases, Peking University First Hospital, Beijing, 100034, China.

Artificial Liver Center, Beijing You-An Hospital, Capital Medical University, Beijing, 100069, China.

出版信息

Hepatol Int. 2019 Jan;13(1):1-21. doi: 10.1007/s12072-018-09923-2. Epub 2019 Jan 18.

Abstract

The Chinese Society of Hepatology developed the current guidelines for the Management of Ascites and Its Related Complications in Cirrhosis based on the published evidences and the panelists' consensus. The guidelines provided recommendations for the diagnosis and management of cirrhotic ascites emphasizing a step-wise approach with the first-, second-, and third-line therapy. For refractory ascites, vasoconstrictors and albumin are recommended for splanchnic vasodilation and selective vasopressin (V2) receptor antagonists for moderate-to-severe hyponatremia. For spontaneous bacterial peritonitis, empirical anti-infection treatment was recommended based on the local microbiological examination of community- or hospital-acquired infections. For hepatorenal syndrome, the administration of vasopressor terlipressin and albumin is recommended.

摘要

中华医学会肝病学分会基于已发表的证据和专家组共识,制定了《肝硬化腹水及相关并发症的管理指南》。该指南针对肝硬化腹水的诊断和管理提供了建议,强调了采用逐步治疗的方法,包括一线、二线和三线治疗。对于难治性腹水,推荐使用血管收缩剂和白蛋白治疗内脏血管扩张,对于中重度低钠血症,推荐使用选择性血管加压素(V2)受体拮抗剂。对于自发性细菌性腹膜炎,建议根据社区或医院获得性感染的局部微生物检查进行经验性抗感染治疗。对于肝肾综合征,推荐使用血管加压素特利加压素和白蛋白治疗。

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