Lebrec D, Kotelanski B, Cohn J N
J Lab Clin Med. 1979 Feb;93(2):301-9.
Splanchnic and systemic hemodynamic observations in eight patients with cirrhosis and refractory ascites were compared to those of 25 patients with cirrhosis and responsive ascites. The refractory ascitic group was characterized by less portasystemic shunting from both the superior mesenteric and splenic vascular beds, a lower cardiac output, a higher systemic vascular resistance, a wider arterial-hepatic venous oxygen difference, and a tendency for a lower HBF and higher postsinusoidal resistance. Portal pressures assessed from hepatic vein catheterization were similar in the two groups. The absence of a well-developed portasystemic collateral bed in patients with refractory ascites could in part be caused by the tense ascites but could also be an important factor in the mechanism of refractory ascites.
对8例肝硬化难治性腹水患者和25例肝硬化反应性腹水患者的内脏和全身血流动力学观察结果进行了比较。难治性腹水组的特点是肠系膜上血管床和脾血管床的门体分流较少、心输出量较低、全身血管阻力较高、动脉-肝静脉氧差较大，且肝血流量有降低趋势、肝窦后阻力较高。通过肝静脉插管评估的门静脉压力在两组中相似。难治性腹水患者缺乏发达的门体侧支循环床，部分原因可能是腹水张力，但也可能是难治性腹水机制中的一个重要因素。
