Khan Nazia, Dushay Kevin M
Warren Alpert Medical School, Brown University, Rhode Island Hospital, Internal Medicine, 593 Eddy St, Providence, RI 02903, USA.
Warren Alpert Medical School, Brown University, Rhode Island Hospital, Pulmonary,Critical Care & Sleep Disorders 593 Eddy St, Providence, RI 02903, USA.
Med Sci (Basel). 2019 Aug 22;7(9):88. doi: 10.3390/medsci7090088.
Ascites, the fluid accumulation in the peritoneal cavity, is most commonly seen in patients with end-stage liver disease (ESLD). Evaluating ascites or providing symptomatic relief for patients is accomplished by performing a paracentesis. Ascites leak from a paracentesis site can be a complication of the procedure and is associated with increased morbidity. Currently, the best options for these patients include medical management or surgical abdominal wall layer closure. Utilizing a blood patch provides an alternative approach to managing such patients. A two-center prospective case series was performed evaluating the efficacy of the blood patch in patients with significant persistent ascites leak following a paracentesis. About 30 mL of the patients' peripheral blood was used for the blood patch. Subjects were recruited over a period of one year and followed for 30 days after the procedure. A total of six patients were recruited for this study. Subjects underwent placement of autologous blood patch at the site of the ascites leak and 100% had resolution of the leak within 24 hours. None of the subjects developed any complications of the procedure. This study shows that an autologous blood patch is an effective, low-risk treatment method for ascites leaks following a paracentesis. It is a simple bedside procedure that can reduce morbidity in patients with end-stage liver disease.
腹水是指腹腔内液体蓄积，最常见于终末期肝病（ESLD）患者。通过进行腹腔穿刺术来评估腹水或为患者提供症状缓解。腹腔穿刺部位的腹水渗漏可能是该操作的一种并发症，并与发病率增加相关。目前，这些患者的最佳选择包括药物治疗或手术关闭腹壁各层。使用血补丁提供了一种管理此类患者的替代方法。进行了一项双中心前瞻性病例系列研究，评估血补丁对腹腔穿刺术后出现大量持续性腹水渗漏患者的疗效。约30毫升患者的外周血用于制作血补丁。在一年时间内招募受试者，并在术后随访30天。本研究共招募了6名患者。受试者在腹水渗漏部位进行了自体血补丁植入，100%的患者渗漏在24小时内得到解决。没有受试者出现该操作的任何并发症。这项研究表明，自体血补丁是治疗腹腔穿刺术后腹水渗漏的一种有效、低风险的治疗方法。这是一种简单的床旁操作，可以降低终末期肝病患者的发病率。
