临床肝胆病杂志2018，Vol.34Issue(1)：31-34,4.DOI:10.3969/j.issn.1001-5256.2018.01.006
从《肝硬化腹水及相关并发症的诊疗指南》探讨肝硬化顽固性腹水诊治"路线图"
Road map of the diagnosis and treatment of intractable ascites based on guidelines for the diagnosis and treatment of cirrhotic ascites and related complications
摘要
Abstract
Guidelines for the diagnosis and treatment of cirrhotic ascites and related complications put forward the new criteria for the diagnosis and treatment of intractable cirrhotic ascites, and spontaneous bacterial peritonitis is a common cause of intractable cirrhotic ascites. About 50％ -89％ of patients with intractable cirrhotic ascites have a significant response to terlipressin (2-8 mg/d), midodrine hydrochloride (22. 5 mg/d), and tolvaptan (7. 5-15 mg/d) . Intravenous albumin supplementation (8 g/1000 ml ascites) has a similar therapeutic effect as terlipressin (3 mg) in preventing posterior circulation dysfunction after large-volume paracentesis. Patients with a poor response to medication or those who need frequent large-volume paracentesis (more than three times per week) or frequent hospitalization (more than three times per month) should be evaluated for liver transplantation or transjugular intrahepatic portosystemic shunt. α-Crystal rifaximin may become a new strategy for preventing complications of liver cirrhosis by regulating the intestine-microbe-liver axis. Therefore, it is of great significance to explore the"road map"of the diagnosis and treatment of intractable cirrhotic ascites that is suitable for the clinical practice in China.关键词
肝硬化/腹水/腹膜炎/诊断/治疗Key words
liver cirrhosis/ascites/peritonitis/diagnosis/therapy分类
医药卫生引用本文复制引用
丁惠国..从《肝硬化腹水及相关并发症的诊疗指南》探讨肝硬化顽固性腹水诊治"路线图"[J].临床肝胆病杂志,2018,34(1):31-34,4.基金项目
北京市医院管理局临床医学发展专项(ZYLX201610) （ZYLX201610）
登峰计划专项(DFL20151602) （DFL20151602）
