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Ascites knowledge

Treatment of ascites

Date:2016-10-18 11:27:12 FROM: Browsing times:
        Due to many causes of ascites, whether ascites was transudative or exudative, can be caused by many kinds of diseases, therefore, in patients with ascites, should as soon as possible to determine the nature of the ascites, then search the pathogeny actively. Only for the cause of treatment, ascites may be reduced or disappeared; if the cause is not yet clear, in order to alleviate the symptoms of a large number of ascites (including abdominal distension, respiratory restriction, etc.) may be necessary for symptomatic treatment. In addition, as due to end-stage liver cirrhosis and severe liver function impairment, connective tissue disease, ascites, although for the cause of treatment, but the ascites often can not be completely dissipated, sometimes even become intractable ascites, in this case, only a comprehensive therapy. Generally speaking, the treatment of ascites can take the following measures.
        1 limit of water and sodium intake of ascites patients, especially the hypoproteinemia caused by, should strictly control the sodium intake, followed by water intake; the diet should be in high sugar, high protein, high vitamin, low fat diet; low salt diet also applies to all of the leakage or seepage of ascites, objective is as much as possible the excess water discharged from the kidneys in vitro.
        2 Application of diuretic drugs in order to accelerate the discharge of water from the kidney, can choose to use diuretic drugs. Under normal circumstances, should be combined with potassium sparing and excretion of potassium diuretics, or combination of effects on different parts of the kidney diuretics, in order to achieve the best diuretic effect, without electrolyte disturbance occurred (especially prevent the increase or decrease of serum potassium). Type and dose of diuretics should follow, and vary the number of ascites due to It differs from man to man. vary with the primary disease principle, in general, can be sucked back through the peritoneal ascites income in the blood, and then excreted through the kidneys, but every day the amount of ascites suction peritoneal blood in a certain income limit, therefore, is not a diuretic dosage the larger, more obvious decrease of ascites. To this end, the dosage of diuretic drugs should be based on different diseases, and should be started from an early age gradually increase the amount of.
        3 supplement of albumin or accelerate protein synthesis such as ascites is mainly due to reduced plasma colloid osmotic pressure caused by the low proteinemia, except in the high protein content of food, should also be appropriate to improve the intravenous supplement of albumin, plasma colloid osmotic pressure. Infusion of albumin, diuretic diuretic effect can be better play, the amount of urine will increase significantly. Studies have found that in recent years, such as the Department of liver disease hypoproteinemia caused by ascites, but by recombinant human growth hormone (Human growth hormone recombinant; Somatropin) treatment, the mechanism is that the drug can promote the synthesis of protein in liver cells, increase the content of serum albumin.
        4 put the ascites treatment when a large number of ascites affect the patient's breathing or the patient's abdominal distension symptoms are heavy and difficult to bear, can be taken to put the treatment of ascites, in order to alleviate the symptoms. The amount of ascites was 1000 ~ 3000ml in each time, and the 20mg was injected into the abdominal cavity after the extraction of ascites, which could enhance the diuretic effect. As a result of a large number of repeated ascites can lead to loss of protein and electrolyte, the chance of ascites infection will increase, it should be avoided.
        5 ascites reinfusion of ascites, jugular venous reflux or transjugular intrahepatic portosystemic shunt (TIPS) system: such as ascites of patients with decompensated liver cirrhosis, portal hypertension, hypoproteinemia caused by transfusion therapy, can be used to be concentrated ascites, ascites after ascites protein and electrolyte material to enter the body through the jugular vein. The silicon rubber tube is inserted into the jugular vein from the abdominal wall and the chest wall through the abdominal wall and the chest wall. The TIPS method has a good effect on reducing the pressure of portal vein and removing ascites, but there is no reversible hepatic encephalopathy.
        6 Application of vasodilators is poor when ascites transudate and large amount of diuretic effect, to improve the blood supply of the kidney, appropriate application of vasodilators, such as intravenous injection of Ligustrazine every 100 ~ 150mg or 20 ~ 40mg dopamine enhances diuretic effect.

 

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