腹水的处理

腹水的发生是腹腔内液体的产生和吸收之间病理性失衡的结果。腹水外观及其成分因其发生的病理生理机制不同而异。腹水最常发生于肝硬化失代偿、腹膜转移癌或结核。某些患者腹水的病因诊断和治疗很困难,是对临床医师的挑战。本文对腹水病因诊断的关键点和相关流程进行了描述,强调血清-腹水白蛋白梯度在病因诊断中的作用,对肝硬化失代偿所致的难治性腹水的处理进行讨论。

Management of Ascites

The development of ascites indicates a pathological imbalance between the production and resorption of intraperitoneal fluid. The appearance and composition of aseites are variable, based on the underlying pathophysiology. Most eommonly, ascites develops in the setting of deeompensated cirrhosis, peritoneal metastasis of carcinoma and tuberculosis. The etiological diagnosis and therapy can be difficult in some eases, and remains a ehallenge for the clinicians. The key points and algorithmic approach to the causes of ascites are outlined, and the role of serum-aseites albumin gradient is emphasized. Management options for refraetory ascites from decompensated liver cirrhosis are discussed.