Hwang J C, Chen J A, Fung H Y
Division of Nephrology, Chi-Mei Foundation Hospital, Tainan, Taiwan.
Am J Kidney Dis. 1996 Dec;28(6):899-903. doi: 10.1016/s0272-6386(96)90391-1.
Patients with end-stage renal disease combined with tense ascites caused by decompensated liver cirrhosis are sometimes encountered in a hemodialysis center. A big problem for the management of these patients is the tendency of hypotension during ultrafiltration. Subsequent fluid accumulation, especially in the abdominal cavity, causes breathing difficulty and abdominal discomfort. We present a new technique, ascites ultrafiltration, to solve this problem. Using the same equipment as for ordinary hemodialysis, and incurring the same cost, we removed directly approximately 8 L of ascites fluid during each nearly 4-hour session. No hemodynamic instability was noted. We proved this technique to be an effective and safe alternative method for this group of patients.
血液透析中心有时会遇到终末期肾病合并失代偿期肝硬化所致大量腹水的患者。这类患者管理中的一个大问题是超滤过程中出现低血压的倾向。随后的液体蓄积，尤其是腹腔内的液体蓄积，会导致呼吸困难和腹部不适。我们提出一种新技术——腹水超滤，以解决这一问题。使用与普通血液透析相同的设备，成本相同，我们在每次近4小时的治疗过程中直接清除了约8升腹水。未观察到血流动力学不稳定情况。我们证明了该技术是这类患者一种有效且安全的替代方法。
