Gonvers J J
Schweiz Med Wochenschr. 1979 Jun 23;109(25):950-3.
The treatment of cirrhotic ascites is based on restriction of dietary sodium and fluid intake coupled with diuretics. Ascitic fluid must always be sampled and infection ruled out. Large abdominal paracenteses are dangerous. Most patients with ascites respond to the dietary-diuretic regimen. The clinician must be watchful for overdiuresis. Some patients need diuretics in ever-increasing doses in an attempt to increase urine flow and are at particular risk of functional renal failure. In these diuretic-resistant cases the ascitic fluid can be withdrawn, ultra-filtered and reinfused by means of suitable apparatus. In 1974, LeVeen and co-workers described a peritoneo-venous shunt system which provides more continuous treatment over many months. The morbidity and mortality of this shunt are difficult to determine from published reports. Long-term controlled studies are needed. The beneficial effect on survival of treatment of cirrhotic ascites is still questioned.
肝硬化腹水的治疗基于限制饮食中钠和液体的摄入并结合利尿剂。必须始终抽取腹水样本并排除感染。大量腹腔穿刺放液是危险的。大多数腹水患者对饮食 - 利尿剂治疗方案有反应。临床医生必须警惕过度利尿。一些患者需要不断增加利尿剂剂量以试图增加尿量，尤其有发生功能性肾衰竭的风险。在这些利尿剂抵抗的病例中，可以通过合适的设备抽出腹水、超滤并重新注入。1974年，LeVeen及其同事描述了一种腹腔 - 静脉分流系统，该系统可在数月内提供更持续的治疗。从已发表的报告中很难确定这种分流术的发病率和死亡率。需要进行长期对照研究。肝硬化腹水治疗对生存率的有益作用仍受到质疑。
