Ascites: its correction by peritoneovenous shunting.
Ascites: its correction by peritoneovenous shunting.
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DOI：
10.1016/s0011-3840(79)80001-5
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发表时间：
1979-02-01
影响因子：
4.4
通讯作者：
Kinney, M
中科院分区：
文献类型：
--
作者：
LeVeen, H H;Wapnick, S;Kinney, M
难治性腹水和 HRS 患者应考虑提出腹腔静脉分流术的紧急指征。分流术提供了一种连续回输腹水的方法，可纠正钠潴留、少尿和氮质血症。严重脑病、黄疸或腹膜败血症（肝硬化的常见并发症）在病情改善之前禁止安装分流器。只要在手术时除去腹水并使用大量利尿剂，相关心脏病并不禁忌使用分流器。事实证明，这种手术对于肝硬化以外原因引起的腹水也很有用。主要并发症包括弥散性血管内凝血、少数患者出现肝昏迷和败血症。一项随机前瞻性研究的结果表明，对于饮食抵抗性大量腹水的患者，甚至在利尿剂治疗无效之前就应该考虑进行分流。
Patients with refractory ascites and HRS should be considered to present an urgent indication for peritoneovenous shunting. The shunt offers a method of continuous reinfusion of ascitic fluid which corrects avid sodium retention, oliguria and azotemia. Severe encephalopathy, jaundice or peritoneal sepsis--common complications of cirrhosis--contraindicate installation of the shunt before improvement occurs. Associated cardiac disease does not contraindicate the use of the shunt provided that ascitic fluid is removed at the time of operation and large amounts of diuretics are used. This operation has also proved useful in ascites attributed to causes other than cirrhosis. The main complications include disseminated intravascular coagulopathy, hepatic coma and sepsis in a few patients. Results of a randomized prospective study indicate that the shunt should probably be considered in patients with diet-resistant massive ascites even before they prove to be refractory to diuretic therapy.