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在治疗肝硬化腹水时,首先应明确:虽然腹水可能引起一些并发症,但腹水本身(除大量者外)一般并不影响病人的预后,也未证明腹水的去除可延长病人的生命。肝硬化腹水的基础治疗为卧床休息和严格限钠,约10%病人可因此而产生自发性利尿,从而使腹水消失。肝病病人的摄钠限量很严(0.25g/d,约10mmol),约为心脏病病人的1/5。如严格的限钠影响了病人的食欲,可考虑减少限钠,加用利尿剂。因高营养饮食与戒酒也是基础治疗的一部份。(参见附图)
When treating cirrhotic ascites, it should first be clear that although ascites may cause some complications, ascites itself (except for large numbers) generally does not affect the patient’s prognosis nor does it prove that the removal of ascites prolongs the patient’s life. The basic treatment for cirrhosis and ascites is bed rest and strict sodium restriction, which can result in spontaneous diuresis in about 10% of patients, causing ascites to disappear. Patients with liver disease sodium intake limit is very strict (0.25g / d, about 10mmol), about one fifth of heart disease patients. Such as strict sodium limit the patient’s appetite, consider reducing sodium restriction, plus diuretics. Because of high nutritional diet and abstinence is also part of basic treatment. (See attached figure)