What a _'s treatment does liver cirrhosis ascites treat progress

What a _'s treatment does liver cirrhosis ascites treat progress
The liver cirrhosis ascites is later period complication with common liver cirrhosis, it is a common pathologic change of hepatopathy in latter stage of end, the intersection of ascites and incidence exceed 50% in the 10 year after liver cirrhosis diagnose for the first time, and patient to erupt simultaneously ascites survival rate is fewer than 50% their 3. The quality that the ascites influences patients to survive after forming, also increase risks such as water electrolytic disorder, spontaneous peritonitis, renal failure,etc., it is a bad index of prognosis. The further investigation of the mechanism with having illness coming on to the liver cirrhosis ascites, the international ascites association has already upgraded the guide of making a diagnosis to the liver cirrhosis ascites, so the making a diagnosis and giving treatment of liver cirrhosis ascites in recent years has progress greatly, this text summarizes at this point.
1,Classify and diagnose
The ascites can be divided into simple ascites and obstinate ascites. The ascites of coexisting in having infecting and liver kidney syndrome is called the simple ascites, it can be divided into light, middle, a large amount of 3 degrees. Until ascites can't disappear, or whom ascites recur quickly call the obstinate ascites treat effective, after treating, the obstinate ascites can be divided into diuretic resisting ascites and diuretic difficult managing ascites, the former refers to limiting the absorption of sodium (2 000 mg/d) With employing heavy dose of diuretic (ester 400 mg/d and furan in spiral shell is filled in the rice 160 mg/d) Ascites of failing to respond to any medical treatment; It causes the ascites difficult to disappear of the ascites that the latter refers to making diuretic unable to reach the best dosage because of side effect that diuretic causes. There is 5%- 10% of the liver cirrhosis ascites that belongs to the obstinate ascites on clinic. Should find out the reason in all ascites, but the abdominal cavity punctures and does not nearly avoid the card to all patients, should avoid using this method only when in mechanism's obvious obstacle of blood coagulation, to with the reason first visit patient of the ascites, or when the obvious change takes place in the liver cirrhosis ascites patient's water yield of belly, should all make diagnosis puncture inspection. Check many reasons to distinguish the ascites by determining the albumen content in the ascites to ascites previously, when the albumen content is greater than or equal to 25 g/L in order to ooze out the liquid, the content lt of albumen; At the 25 g/L for leak liquid, but this method is not so good as blood plasma and ascites albumen ratio (SAAG) Can ocular dividing high pressure and inflammation and abdominal cavity's tumouring of portal vein into by sensitive area, so recommend the reason to distinguish the ascites with SAAG, the rate of accuracy can be up to 97%. It is the high pressure ascites of portal vein, SAAGlt when SAAG is greater than or equal to 11 g/L; 11 g/L the intersection of door and the intersection of pulse and high pressure ascites, inflammation and the intersection of abdominal cavity and due to tumour ascites, and should make the ascites cytologic checking or determination of the amylase at the same time when suspecting malignant tumour or pancreatitis. For have the intersection of blood coagulation and the intersection of mechanism and patient of obstacle, peritoneoscope technology can ocular to help image those learn, check, define the ascites patient of the cause of disease makes diagnosis while being difficult. Zhang Bing is far,etc. [4 ] and is learnt to check the difficult competent diagnosing laparoscopy of ascites patient who define cause of disease to 56 by many kinds of images, there was not operation complication finally, and the accuracy rate of diagnosis was up to 92.8%. That is to say diagnosing laparoscopy is a safe and accurate diagnostic method of ascites patient of unidentified reason.
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