Wilkinson S P
Derriford Hospital, Plymouth, UK.
Eur J Gastroenterol Hepatol. 1998 Jan;10(1):1-3. doi: 10.1097/00042737-199801000-00001.
Ascites due to cirrhosis can usually be managed successfully by dietary sodium restriction and carefully monitored diuretic therapy. However, paracentesis with an albumin infusion is a relatively safe alternative that has gained widespread acceptance. Other plasma expanders offer a cheaper alternative to albumin. Other recently developed techniques include peritoneovenous shunt and transjugular intrahepatic portosystemic stent shunt. Each of these is associated with an operative mortality and substantial complications, but for diuretic-resistant ascites a peritoneovenous shunt has comparable results to paracentesis/albumin. For patients with spontaneously occurring renal failure the prognosis is poor. None of the above treatments improves renal function. Management should therefore be symptomatic with paracentesis as necessary.
肝硬化引起的腹水通常可通过限制饮食中的钠摄入和密切监测利尿剂治疗而成功控制。然而，腹腔穿刺术并输注白蛋白是一种相对安全的替代方法，已得到广泛认可。其他血浆扩容剂是白蛋白较便宜的替代品。最近开发的其他技术包括腹腔静脉分流术和经颈静脉肝内门体分流术。这些方法均伴有手术死亡率和严重并发症，但对于利尿剂抵抗性腹水，腹腔静脉分流术与腹腔穿刺术/白蛋白输注效果相当。对于自发性肾衰竭患者，预后较差。上述治疗均不能改善肾功能。因此，应根据需要进行腹腔穿刺术，以缓解症状。
