Simon D M, McCain J R, Bonkovsky H L, Wells J O, Hartle D K, Galambos J T
Hepatology. 1987 May-Jun;7(3):423-9. doi: 10.1002/hep.1840070302.
Thirteen patients with cirrhosis and tense ascites (six with and seven without peripheral edema) underwent 4- to 15-liter paracentesis without intravenous "colloid" replacement. Cardiac output increased from 6.6 +/- 0.7 liters per min at baseline to 8.2 +/- 0.7 liters per min (p less than 0.003) 1 hr after large-volume paracentesis completion and fell to 7.5 +/- 0.69 liters per min (p less than 0.05 vs. baseline, p less than 0.02 vs. 1 hr) 24 hr after large-volume paracentesis completion. There was no change in mean arterial pressure or mean pulmonary artery pressure. Central venous pressure fell from 9.1 +/- 0.8 mm Hg at baseline to 8.6 +/- 1.4 mm Hg 1 hr post-large-volume paracentesis to 6.8 +/- 1.0 mm Hg (p less than 0.005 vs. baseline, p less than 0.02 vs. 1 hr value) at 24 hr, and pulmonary capillary wedge pressure fell from 13.1 +/- 0.9 to 11.1 +/- 1.3 mm Hg 1 hr after large-volume paracentesis and to 9.89 +/- 1.2 (p less than 0.01 vs. baseline, p less than 0.03 vs. 1 hr after large-volume paracentesis) at 24 hr. Heart rate fell from 90 +/- 3.0 to 85 +/- 2.9 beats per min (p less than 0.01) 1 hr after large-volume paracentesis completion, but increased to 89 +/- 2.5 beats per min (p less than 0.02 vs. 1 hr after large-volume paracentesis) at 24 hr.(ABSTRACT TRUNCATED AT 250 WORDS)
13例肝硬化并张力性腹水患者（6例伴有外周水肿，7例无外周水肿）接受了4至15升的腹腔穿刺放液，未进行静脉“胶体”替代治疗。大量腹腔穿刺放液结束后1小时，心输出量从基线时的6.6±0.7升/分钟增加至8.2±0.7升/分钟（p<0.003），而在大量腹腔穿刺放液结束后24小时，心输出量降至7.5±0.69升/分钟（与基线相比p<0.05，与1小时时相比p<0.02）。平均动脉压和平均肺动脉压无变化。中心静脉压从基线时的9.1±0.8毫米汞柱在大量腹腔穿刺放液后1小时降至8.6±1.4毫米汞柱，在24小时时降至6.8±1.0毫米汞柱（与基线相比p<0.005，与1小时时的值相比p<0.02），肺毛细血管楔压在大量腹腔穿刺放液后1小时从13.1±0.9降至11.1±1.3毫米汞柱，在24小时时降至9.89±1.2（与基线相比p<0.01，与大量腹腔穿刺放液后1小时相比p<0.03）。大量腹腔穿刺放液结束后1小时心率从90±3.0降至每分钟心跳85±2.9次（p<0.01），但在24小时时增加至89±2.5次/分钟（与大量腹腔穿刺放液后1小时相比p<0.02）。（摘要截选至250字）
