Management of ascites in cirrhosis.
Management of ascites in cirrhosis.
复制标题
DOI：
10.1016/j.cld.2005.07.008
复制
发表时间：
2005-11-01
影响因子：
5.1
通讯作者：
Sanyal, Arun J
中科院分区：
文献类型：
--
作者：
Sandhu, Bimaljit Singh;Sanyal, Arun J
发生于肝硬变的腹水与生活质量恶化、自发性细菌性腹膜炎和肾功能衰竭的风险增加有关。门脉高压产生内脏血管扩张，触发一系列事件，导致钠保留血管收缩激素的释放。治疗肝硬变腹水的基础是改善利尿剂的钠排泄，限制饮食中的钠。顽固性腹水和肝肾综合征是腹水的并发症，具有非常高的死亡率。大容量穿刺术和经颈静脉肝内门体分流术是治疗顽固性腹水的有效方法。肝移植是提高肝硬变腹水存活率的唯一方法。
Onset of ascites in cirrhosis of the liver is associated with worsened quality of life, increased risk of spontaneous bacterial peritonitis, and renal failure. Portal hypertension produces splanchnic vasodilation that triggers the cascade of events leading to release of Na retentive vasoconstrictor hormones. Management of ascites caused by cirrhosis is based on improving the Na excretion with diuretics and Na restriction in diet. Refractory ascites and hepatorenal syndrome are the complications of ascites that carry a very high mortality. Large volume paracentesis and transjugular intrahepatic porto-systemic shunts are useful in managing patients with refractory ascites. Liver transplant is the only way to improve survival in ascites caused by cirrhosis.