Khan Muhammad Abdullah, Mughal Hafiz Muhammad Faizan, Ahmed Shehwar, Khaliq M, Ghafoor Abdul
General Medicine, King's Mill Hospital, Sutton-In-Ashfield, GBR.
Internal Medicine, Khawaja Muhammad Safdar Medical College, Sialkot, PAK.
Cureus. 2025 Jun 14;17(6):e86016. doi: 10.7759/cureus.86016. eCollection 2025 Jun.
Many people with liver cirrhosis develop recurrent ascites that requires repeated treatments of large-volume paracentesis (LVP). This study aimed to determine whether intravenous albumin treatment extends the interval between paracentesis procedures, while also preventing paracentesis-induced circulatory dysfunction (PICD) and renal dysfunction among cirrhotic patients who experience recurrent ascites.
This prospective cohort study was carried out at a tertiary care hospital in Pakistan from April 2023 to August 2023, including 120 patients undergoing LVP treatment for cirrhosis were divided into two equal groups. OpenEpi version 3.0.0 (released 2013, developed by Andrew G. Dean, Kevin M. Sullivan, and Daniel G. Soe, Atlanta, GA, USA) was used for calculation. The 60 patients in Group A received albumin, while 60 in Group B received only saline. Over four months, outcomes were evaluated. The statistical analysis was performed using IBM SPSS Statistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, New York, United States).
Group A experienced a prolonged time interval between paracentesis treatments (18.2 vs. 11.1 days, p < 0.001) and a reduced occurrence of PICD (7 (11.7%) vs. 23 (38.3%), p = 0.001) and renal dysfunction (6 (10.0%) vs. 18 (30.0%), p = 0.008). The patients in Group A experienced reduced incidents of hospitalizations, together with emergency procedures. This highlighted the greater efficacy of albumin than saline.
Using albumin in therapy decreased the risks of recurring fluid buildup in cirrhotic patients, as it helped in prolonging the time between repeated fluid removal procedures. However, due to a single-center approach, the generalizability of the results was limited. Nonetheless, albumin administration at the standardized intervals should become part of the therapeutic regimen because it ensures patients' safety and reduces the workload on medical staff.
许多肝硬化患者会出现反复腹水，需要反复进行大量腹腔穿刺放液（LVP）治疗。本研究旨在确定静脉输注白蛋白治疗是否能延长腹腔穿刺放液治疗间隔时间，同时预防反复出现腹水的肝硬化患者发生穿刺诱导的循环功能障碍（PICD）和肾功能障碍。
本前瞻性队列研究于2023年4月至2023年8月在巴基斯坦一家三级医疗医院进行，纳入120例接受LVP治疗的肝硬化患者，分为两组，每组60例。使用OpenEpi 3.0.0版本（2013年发布，由美国佐治亚州亚特兰大的Andrew G. Dean、Kevin M. Sullivan和Daniel G. Soe开发）进行计算。A组60例患者接受白蛋白治疗，B组60例患者仅接受生理盐水治疗。在四个月的时间里评估结果。使用IBM SPSS Statistics for Windows 26版（2019年发布；IBM公司，美国纽约州阿蒙克）进行统计分析。
A组腹腔穿刺放液治疗间隔时间延长（18.2天对11.1天，p<0.001），PICD发生率降低（7例（11.7%）对23例（38.3%），p = 0.001），肾功能障碍发生率降低（6例（10.0%）对18例（30.0%），p = 0.008）。A组患者住院及急诊手术发生率降低。这突出了白蛋白比生理盐水更有效。
在治疗中使用白蛋白降低了肝硬化患者反复出现积液的风险，因为它有助于延长反复放液治疗之间的时间间隔。然而，由于采用单中心研究方法，结果的可推广性有限。尽管如此，按照标准化间隔给予白蛋白应成为治疗方案的一部分，因为它可确保患者安全并减轻医务人员的工作量。
