Runyon B A
Loma Linda Transplantation Institute, CA 92354, USA.
Hepatology. 1998 Jan;27(1):264-72. doi: 10.1002/hep.510270139.
Ascites is the most common of the major complications of cirrhosis. The development of ascites is an important landmark in the natural history of cirrhosis and has been proposed as an indication for liver transplantation. The initial evaluation of a patient with ascites should include a history, physical evaluation, and abdominal paracentesis with ascitic fluid analysis. Treatment should consist of abstinence from alcohol, sodium restricted diet, and diuretics. This regimen is effective in approximately 90% of patients. The treatment options for the diuretic-resistant patients include serial therapeutic paracenteses, liver transplantation, and peritoneovenous shunting.
腹水是肝硬化最常见的主要并发症。腹水的出现是肝硬化自然病程中的一个重要标志，并且已被提议作为肝移植的指征。对腹水患者的初步评估应包括病史、体格检查以及进行腹水穿刺并分析腹水。治疗应包括戒酒、限制钠摄入饮食以及使用利尿剂。该治疗方案对大约90%的患者有效。对利尿剂抵抗患者的治疗选择包括系列治疗性腹腔穿刺放液、肝移植以及腹腔静脉分流术。
