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肝硬化腹水的引流

Drainage of ascites in cirrhosis.

作者信息

Yang Jia-Xing, Peng Yue-Ming, Zeng Hao-Tian, Lin Xi-Min, Xu Zheng-Lei

机构信息

Department of Gastroenterology, The Second Clinical Medical College, Jinan University, Shenzhen 518000, Guangdong Province, China.

Department of Nursing, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, Shenzhen 518000, Guangdong Province, China.

出版信息

World J Hepatol. 2024 Sep 27;16(9):1245-1257. doi: 10.4254/wjh.v16.i9.1245.

Abstract

For cirrhotic refractory ascites, diuretics combined with albumin and vasoactive drugs are the first-line choice for ascites management. However, their therapeutic effects are limited, and most refractory ascites do not respond to medication treatment, necessitating consideration of drainage or surgical interventions. Consequently, numerous drainage methods for cirrhotic ascites have emerged, including large-volume paracentesis, transjugular intrahepatic portosystemic shunt, peritoneovenous shunt, automated low-flow ascites pump, cell-free and concentrated ascites reinfusion therapy, and peritoneal catheter drainage. This review introduces the advantages and disadvantages of these methods in different aspects, as well as indications and contraindications for this disease.

摘要

对于肝硬化难治性腹水,利尿剂联合白蛋白和血管活性药物是腹水管理的一线选择。然而,它们的治疗效果有限,大多数难治性腹水对药物治疗无反应,因此需要考虑引流或手术干预。因此,出现了许多针对肝硬化腹水的引流方法,包括大量腹腔穿刺放液、经颈静脉肝内门体分流术、腹腔静脉分流术、自动低流量腹水泵、无细胞浓缩腹水回输疗法和腹膜导管引流。本文综述了这些方法在不同方面的优缺点,以及该疾病的适应证和禁忌证。

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