Hobar P C, Turner W W, Valentine R J
Surgery. 1987 Feb;101(2):161-4.
Tense ascites in patients who require hemodialysis for renal failure (nephrogenic ascites) is a rare but ominous complication. Its appearance is often followed by a rapid physical deterioration. Nonsurgical attempts to control the ascites are often unsuccessful. Four patients with refractory ascites were treated with Denver peritoneovenous shunts (DPVS). These patients suffered from ventilatory failure, anorexia with malnutrition, and hypotension during hemodialysis. Patients were followed for as long as 18 months after DPVS, and all experienced clinical resolution of the ascites. Ventilatory failure, malnutrition, and hypotension either improved or resolved after shunting. Shunt-related morbidity occurred in all patients and consisted of mechanical complications in four patients and bacteremia in one patient. These problems were resolved by either revision or removal of the DPVS. No deaths were directly related to shunting. Peritoneovenous shunting successfully treats nephrogenic ascites and reverses the morbid sequelae usually associated with this syndrome.
因肾衰竭需要进行血液透析的患者出现的紧张性腹水（肾源性腹水）是一种罕见但预后不良的并发症。其出现后患者身体状况往往会迅速恶化。非手术方法控制腹水常常不成功。4例难治性腹水患者接受了丹佛腹腔静脉分流术（DPVS）治疗。这些患者在血液透析期间出现呼吸衰竭、伴有营养不良的厌食和低血压。DPVS术后对患者进行了长达18个月的随访，所有患者腹水均临床消退。分流术后呼吸衰竭、营养不良和低血压均有所改善或消退。所有患者均出现了与分流相关的并发症，其中4例出现机械性并发症，1例出现菌血症。这些问题通过对DPVS进行修复或移除得以解决。没有死亡与分流直接相关。腹腔静脉分流术成功治疗了肾源性腹水，并逆转了通常与此综合征相关的不良后遗症。
