Forouzandeh B, Konicek F, Sheagren J N
Department of Internal Medicine, Illinois Masonic Medical Center, Chicago 60657-5193, USA.
J Clin Gastroenterol. 1996 Apr;22(3):207-10. doi: 10.1097/00004836-199604000-00011.
Ascites is a common complication of cirrhosis and has a major clinical impact on the patient's general well-being. Approximately 10% of patients with cirrhosis can develop diuretic-resistant, tense ascites that requires other therapeutic interventions. In recent years, there has been a renewed interest in large-volume paracentesis (LVP) as a safe, simple, and inexpensive method to substitute for other more complicated and costly therapeutic interventions for refractory ascites. In this article, we review the latest literature supporting the use of LVP for the treatment of refractory, tense ascites. We also address the role of intravascular volume expansion after LVP, note that usually no postparacentesis volume expansion is necessary, and compare, when used, the different plasma volume expanders in terms of efficacy, safety, and cost.
腹水是肝硬化的常见并发症，对患者的总体健康状况有重大临床影响。约10%的肝硬化患者会出现利尿剂抵抗的张力性腹水，需要其他治疗干预措施。近年来，大量腹腔穿刺放液术（LVP）作为一种安全、简单且廉价的方法，可替代其他更复杂、成本更高的难治性腹水治疗干预措施，重新引起了人们的关注。在本文中，我们回顾了支持使用LVP治疗难治性张力性腹水的最新文献。我们还讨论了LVP后血管内容量扩充的作用，指出通常无需进行穿刺后容量扩充，并在使用时比较了不同血浆容量扩充剂在疗效、安全性和成本方面的差异。
