临床试验证实,用腹水或血浆间断扩充血浆容量,虽能防止由肝硬化腹水引起的急性肾衰竭发生,但不能降低肾衰竭死亡率。只有连续扩充血浆容量才能维持肾功能。给腹水狗施行腹腔静脉分流术,腹水即可消失。即使再给予高钠饮食,腹水也不会重新出现,但会出现外周水肿。分流后,一般不需再用利尿剂,除非病员同时有轻度心衰引起的外周水肿。腹水来自血液,亦应返流回血液,因此腹腔静脉分流术是治疗肝硬化腹水的生理性疗法。利尿剂治疗重度腹水,外周水肿首先消失。但一旦腹水排出时,肾功能也开始受损,表现为血清尿素氮或肌酐值增高。腹水消失与血浆容量降低有密切关系,减 Clinical trials confirm that intermittent expansion of plasma volume with ascites or plasma prevents acute renal failure caused by cirrhotic ascites but does not reduce mortality from renal failure. Only continuous expansion of plasma volume in order to maintain renal function. Ascites dogs peritoneal shunt, ascites can disappear. Even with a high sodium diet, ascites does not reappear, but peripheral edema can occur. After shunt, generally do not need to use diuretics, except for patients with mild heart failure caused by peripheral edema. Ascites from the bloodstream should also be back to the bloodstream, so celiac venous bypass is a physiologic therapy for the treatment of cirrhosis and ascites. Diuretic treatment of severe ascites, peripheral edema disappeared first. However, as soon as ascites were excreted, renal function began to deteriorate, as demonstrated by elevated serum urea nitrogen or creatinine. Ascites disappeared and decreased plasma volume are closely related, less