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作 者:王连江[1]
出 处:《中国全科医学》2011年第9期942-944,共3页Chinese General Practice
摘 要:有些腹腔积液的肝硬化患者利尿剂对其不再起作用。一旦排除形成腹腔积液的其他原因,如门静脉血栓形成、感染、恶性肿瘤、不按医嘱服药、不遵守低钠饮食,依据严格的标准可诊断为顽固性腹腔积液。顽固性腹腔积液患者预后很差,因此最终需通过肝移植才能治愈。目前的重点是在等待肝移植的过程中寻求有针对性的治疗方案。大容量穿刺术(LVP)和经颈静脉肝内门体支架分流术(TIPS)是两种治疗顽固性腹腔积液的主要方案。也有许多其他治疗方法,但还没有得到广泛地使用。本文主要对肝硬化顽固性腹腔积液患者的评估和治疗进行综述。Some patients with ascites due to liver cirrhosis become no longer responsive to diuretics.Once other causes for ascites such as portal vein thrombosis,malignancy or infection and non-compliance with medications or low sodium diet have been excluded,the diagnosis of refractory ascites can be made based on strict criteria.Patients with refractory ascites have very poor prognoses and therefore cured only by liver transplantation.Targeted therapy should be found before liver transplantation.Currently,serial large volume paracentesis(LVP) and transjugular intrahepatic portosystemic stent-shunt(TIPS) are mainstay treatments for refractory ascites.Other options are available but not widely used.This paper describes the evaluation and management of patients with refractory ascites.
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