肝硬化顽固性腹水治疗的进展 肝硬化顽固性腹水内科治疗的进展

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肝硬化腹水病人住院6周以上,经过限制钠、水的摄入,大剂量利尿剂的内科严格治疗后,腹水没有明显减少,尿钠低于10mmol/24h肌酐清除率下降到20~50ml/min者,称顽固性腹水,亦称抗利尿剂性腹水。此时利尿剂不可无限期的使用,亦不可无限量的增加,如继续使用,很易出现低钠血症或肝肾综合征,预后严重。故须迅速停用利尿剂,仍须严格限制钠的摄入。有关顽固性腹水的治疗,近年虽有一定的进展,但未得到完全解决。 Patients with cirrhosis and ascites were hospitalized for more than 6 weeks. After restricting the sodium and water intake, there was no significant reduction of ascites after the strict medical treatment of high-dose diuretics. The creatinine clearance rate of urine less than 10mmol / 24h decreased to 20 ~ 50ml / min Who, said refractory ascites, also known as antidiuretic ascites. At this point diuretic can not be used indefinitely, nor an unlimited increase, such as continue to use, it is prone to hyponatremia or hepatorenal syndrome, the prognosis is serious. Therefore, the need to quickly disable diuretics, still must be strictly limited sodium intake. The treatment of refractory ascites, although some progress in recent years, but not been completely resolved.
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