摘要
有关肝硬化腹水防治一直是临床研究的热点难点。2012年美国肝病研究学会(AASLD)对其2009年制定的"成人肝硬化腹水处理指南"进行了更新,其内容更丰富、严谨,包括腹水的诊断和治疗、自发性细菌性腹膜炎(SBP)与肝肾综合征(HRS)的防治以及白蛋白在肝硬化腹水的临床应用等。同时,新版指南更注意细节,如对腹水培养增加了厌氧菌检查,使之更符合临床实际。然而,作为指南只是提出了指导性意见,而在临床中的治疗方案,尚需临床医师结合具体情况而定。如抗菌药物的选用原则与我国实际情况就存在较大差距,不一定适用。
Diagnosis and management of ascites due to liver cirrhosis is a hotspot of clinical studies. In 2012,the American Society for the Study of Liver Diseases( AASLD) updated the Management of Adult Patients with Ascites Due to Cirrhosis issued in 2009,the contents became more abundant and serious,including the diagnosis and treatment of ascites,spontaneous bacterial peritonitis, hepatorenal syndrome and the clinical use of albumin in cirrhotic ascites, etc.Meanwhile,the new guideline paid more attention to issues in detail,such as the addition of anaerobic culture of ascites,which was more in line with clinical practice. However,as a guideline it can only provide instructive guidance and specific management plan should be designed based on specific situation; for example,there are discordances in principle of antibiotic selection with the actual situation in China,and not infrequently it could not be adopted.
出处
《胃肠病学》
2014年第10期577-582,共6页
Chinese Journal of Gastroenterology
关键词
肝硬化
腹水
自发细菌性腹膜炎
肝肾综合征
白蛋白类
Liver Cirrhosis
Ascites
Spontaneous Bacterial Peritonitis
Hepatorenal Syndrome
Albumins
