Watanabe A
Third Department of Internal Medicine, Faculty of Medicine, Toyama Medical and Pharmaceutical University, Japan.
J Med. 1997;28(1-2):21-30.
Serum-ascites fluid albumin concentration gradient, ascites fluid polymorphonuclear cell count and ascites fluid cytology afford immediate diagnosis of the etiology of ascites. When cirrhotic patients with marked ascites do not respond to diuretics, abdominal paracentesis is the next step, if the ascites is severe enough to justify the risk. When all else fails over a period of several months, a peritoneovenous shunt may be appropriate. We have many options in the management of ascites now, but, in the future, the optimal therapy will include potent and nontoxic diuretic drugs and high-volume paracentesis.
血清腹水白蛋白浓度梯度、腹水多形核细胞计数及腹水细胞学检查有助于立即诊断腹水的病因。当有明显腹水的肝硬化患者对利尿剂无反应时，如果腹水严重到足以承担风险，下一步应进行腹腔穿刺术。当在几个月的时间里所有其他方法都失败时，腹膜静脉分流术可能是合适的。目前我们在腹水的治疗上有很多选择，但在未来，最佳治疗方法将包括强效且无毒的利尿药物和大量腹腔穿刺放液术。
