Reynolds T B, Lieberman F L, Goodman A R
Gut. 1978 Jun;19(6):549-53. doi: 10.1136/gut.19.6.549.
Two modifications of the standard method of treatment of ascites in chronic liver disease were investigated in three separate randomised trials involving a total of 201 patients. These modifications were (1) an unrestricted sodium intake and (2) limitation of diuresis to partial removal of ascites, to the point of relief of abdominal tension. Mean serum sodium fell significantly in all patient groups receiving the low sodium diet and did not fall in the groups given an unrestricted diet. Mean serum urea nitrogen rose significantly in the patient groups undergoing complete diuresis and did not change in the groups undergoing partial diuresis. Mean serum uric acid rose only in the groups undergoing complete diuresis. We concluded that the advantages of these two modifications of therapy of ascites were increased dietary palatability and decreased likelihood of hyponatraemia and of rise in serum urea nitrogen and uric acid. Disadvantages included dissatisfaction of patients over incomplete clearing of ascites, occasional difficulty in performing diagnostic studies because of prolonged ascites, and unsuitability of a high sodium intake in patients whose ascites is highly refractory to treatment.
在三项独立的随机试验中，对慢性肝病腹水标准治疗方法的两种改良方法进行了研究，共有201名患者参与。这些改良方法为：（1）钠摄入不受限制；（2）将利尿限制在部分消除腹水，达到缓解腹部张力的程度。接受低钠饮食的所有患者组血清钠均值显著下降，而给予无限制饮食的组血清钠均值未下降。进行完全利尿的患者组血清尿素氮均值显著升高，而进行部分利尿的组血清尿素氮均值未改变。仅进行完全利尿的组血清尿酸升高。我们得出结论，这两种腹水治疗改良方法的优点是饮食适口性增加，低钠血症以及血清尿素氮和尿酸升高的可能性降低。缺点包括患者对腹水未完全清除不满意，因腹水持续时间长偶尔难以进行诊断研究，以及对于腹水治疗高度难治的患者高钠摄入不合适。
