肝硬化难治性腹腔积液治疗的研究进展  

Research progress in the treatment of refractory ascites in cirrhosis

作　　者：魏淑君 刘苑斌 陈明锴[1] WEI Shujun;LIU Yuanbin;CHEN Mingkai(Department of Gastroenterology,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院消化内科,湖北武汉430060

出　　处：《胃肠病学和肝病学杂志》2024年第12期1726-1730,共5页Chinese Journal of Gastroenterology and Hepatology

基　　金：湖北省重点研发计划项目(2020BCB007)。

摘　　要：腹腔积液是失代偿期肝硬化的常见并发症之一,治疗基础包括限盐、利尿,约10%的患者对常规大剂量利尿剂治疗无效或不耐受,进而发展为难治性腹腔积液。腹腔穿刺大量放液联合白蛋白输注、经颈静脉肝内门体分流分别是难治性腹腔积液的一线、二线治疗方式,利福昔明、米多君、托伐普坦等药物也被证明可用于症状的改善。近年来,对不同治疗方式的安全性和有效性的探索逐渐增多,未来可能为难治性腹腔积液患者的治疗提供更多选择。Ascites is one of the common complications of decompensated cirrhosis,and the treatment basis includes salt restriction and diuresis.About 10%of patients with ascites will be ineffective or intolerable to conventional large-dose diuretic therapy and develop into refractory ascites.Large volume paracentesis with albumin infusion and transjugular intrahepatic portosystemic shunt have become the first-line and the second-line treatment methods.Modalities such as Rifaximin,Midodrine,Tolvaptan and other drugs have also been proved to be useful for the relief of refractory ascites.In recent years,the exploration of the safety and efficacy of the treatment of refractory ascites has gradually increased,which may provide more options for the treatment of patients with refractory ascites in the future.

关 键 词：肝硬化 难治性腹腔积液 药物治疗 腹腔积液引流 介入治疗 

分 类 号：R575[医药卫生—消化系统]