Rudler Marika, Mallet Maxime, Sultanik Philippe, Bouzbib Charlotte, Thabut Dominique
Intensive Care Unit, Hepatology Department, Pitié-Salpêtrière Hospital, Paris, France.
Sorbonne University, UPMC University Paris 06, AP-HP, Pitié-Salpêtrière Hospital, Paris, France.
Liver Int. 2020 Feb;40 Suppl 1:128-135. doi: 10.1111/liv.14361.
Ascites is the most common complication of cirrhosis, which develops in 5%-10% of patients per year. Its management is based on symptomatic measures including restriction of sodium intake, diuretics and paracentesis. Underlying liver disease must always be treated and may improve ascites. In some patients, ascites is not controlled by medical therapies and has a major impact on quality of life and survival. TIPS placement and liver transplantation must therefore be discussed. More recently, repeated albumin infusions and Alfapump have emerged as new therapies in ascites. In this review, the current data on these different options are analysed and an algorithm to help the physician make clinical decisions is suggested.
腹水是肝硬化最常见的并发症，每年有5% - 10%的患者会出现腹水。其治疗基于对症措施，包括限制钠摄入、使用利尿剂和进行腹腔穿刺放液。必须始终对潜在的肝脏疾病进行治疗，这可能会改善腹水情况。在一些患者中，药物治疗无法控制腹水，腹水对生活质量和生存率有重大影响。因此，必须讨论经颈静脉肝内门体分流术（TIPS）置入和肝移植。最近，重复输注白蛋白和Alfapump已成为腹水的新治疗方法。在本综述中，分析了关于这些不同选择的现有数据，并提出了一种帮助医生做出临床决策的算法。
