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在应用有效利尿剂治疗肝硬化腹水之前,经常采用大量腹穿放液,后因顾虑造成直立性低血压、肾功能不全以至急性肾功衰竭、低钠血症、肝性脑病等并发症而避免应用.鉴于腹穿放液临床上颇有效果,本文对18例慢性肝病所致大量腹水伴外周水肿作前瞻性观察,以评价大量腹穿放液对血容量的影响.材料与方法:慢性肝病患者18例,男15,女3,年龄35～77岁.所有患者均有大量腹水引起的呼吸困难并伴末梢凹陷性水肿,无心脏病、慢性肾病的临床及实验室证据,无活动性胃肠道出血及肝性脑病.肾功能稳定,放液前3日多次(或连续)测血肌酐,变动<0.2mg/dl.放液前均限钠500mg/d及限水1000ml/d,并停用利尿药至少3天.然后在30～90分钟内放液5000ml.放液前及放液后24和48小时测定血肌酐、尿素氮
In the application of effective diuretics in the treatment of cirrhotic ascites, often using a lot of abdominal paracentesis, due to concerns caused by orthostatic hypotension, renal insufficiency and acute renal failure, hyponatremia, hepatic encephalopathy and other complications and avoid In view of the clinical efficacy of abdominal paracentesis is quite effective, this paper 18 cases of chronic liver disease caused by a large number of ascites with peripheral edema for prospective observation to evaluate a large number of abdominal paracentesis on blood volume.Materials and Methods: Chronic liver disease 18 patients, male 15, female 3, age 35 to 77. All patients had a large number of ascites-induced dyspnea with peripheral depression edema, no heart disease, clinical and laboratory evidence of chronic kidney disease, no active gastrointestinal Tract hemorrhage and hepatic encephalopathy.Retine function is stable, the blood creatinine is measured repeatedly (or continuously) for 3 days before the change, the change is less than 0.2mg / dl, the limit sodium 500mg / d and the limit of water 1000ml / d Discontinue diuretic drugs for at least 3 days and then release 5000ml within 30-90 minutes.Serum creatinine and urea nitrogen were measured before and 24 and 48 hours after draining