Wapnick S, Grosberg S, Kinney M, Azzara V, LeVeen H H
Arch Surg. 1978 May;113(5):581-5. doi: 10.1001/archsurg.1978.01370170043006.
Renal failure occurs in ascites of diverse causes. Functional renal failure (the hepatorenal syndrome) in cirrhotic patients is usually progressive and rapidly fatal. Insertion of a LeVeen shunt significantly reduces weight, as well as abdominal girth, and improves preoperative urine flow (488 vs 2,318 ml/24 hr; P less than .001) and natriuresis (12 +/- 15 vs 45 +/- 33 mEq/liter; P less than .003). The shunt should not be inserted in patients with alcoholic hepatitis (bilirubin level greater than 8 mg/100 ml). Ascitic fluid should be discarded at the time of surgery in patients with impaired cardiac function, a bleeding diathesis, and when liver function is more severely deranged.
肾衰竭可发生于各种病因所致的腹水。肝硬化患者的功能性肾衰竭（肝肾综合征）通常呈进行性发展且迅速致命。插入LeVeen分流管可显著减轻体重及腹围，并改善术前尿量（488 vs 2318 ml/24小时；P<0.001）和尿钠排泄（12±15 vs 45±33 mEq/升；P<0.003）。酒精性肝炎患者（胆红素水平>8 mg/100 ml）不应插入分流管。对于心功能受损、有出血倾向以及肝功能严重紊乱的患者，手术时应丢弃腹水。
