肝硬化腹水管理新策略——长期白蛋白治疗  

A new strategy for the management of ascites in liver cirrhosis:A long⁃term albumin treatment

作　　者：文蕾 俞慧宏[2] 凌贤龙 WEN lei;YU Huihong;LING Xianlong(Department of Gastroenterology,Shapingba Hospital,Chongqing University,Chongqing 400030,China;不详)

机构地区：[1]重庆大学附属沙坪坝医院消化内科,重庆400030 [2]重庆医科大学附属第二医院消化内科,重庆400010 [3]陆军军医大学附属新桥医院消化内科,重庆400030

出　　处：《实用医学杂志》2024年第5期591-595,共5页The Journal of Practical Medicine

基　　金：第六批重庆市中青年医学高端人才计划资助项目。

摘　　要：腹水是失代偿期肝硬化患者最常见的并发症,目前缺少有效的管理策略,导致腹水反复发生,甚至并发自发性腹膜炎、肝肾综合征、肝衰竭,增加病死率。白蛋白治疗肝硬化腹水由来已久,但通常局限于间断、短期治疗,相对而言,长期白蛋白治疗是一种全然不同的治疗观点,近期多项临床实验提示,对于部分肝硬化失代偿患者,足够剂量、足够时间的白蛋白治疗可能改善疾病病程。本文通过分析近期发表的长期白蛋白治疗的试验数据,探讨可能安全有效的治疗方案,包括最大获益人群、白蛋白剂量、时间、停药标准等,为临床工作提供参考。Ascites is the most frequent decompensating event of cirrhosis.At present,ascites recurs at a high rate due to lack of effective management strategy and is frequently complicated with spontaneous bacterial peritonitis,hepatorenal syndrome,and liver failure,which increase the fatality rate.Albumin treatment for hepatocirrhosic ascites has a long history,but it is limited as an acute or short-term treatment.In contrast,long-term albumin administration represents a completely different treatment paradigm.Results from several recent clinical studies indicate that long-term albumin treatment can be able to modify the disease courses of some decompensated cirrhosis when albumin is given at a sufficient dose for a sufficient time.In this review,we analyze the available data acquired from long-term albumin treatments,trying to establish a secure and effective management scheme involving maximal target popula-tion,albumin dose,administration time,and standards for albumin withdrawal,and thus provide references for the clinical practice.

关 键 词：长期白蛋白 有效白蛋白 腹水 肝硬化失代偿 

分 类 号：R657.31[医药卫生—外科学]