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肝硬化腹水治疗中,利尿剂的合理应用是以对腹水形成的病理生理和对利尿剂作用机理的充分认识为基础的。本文通过对肝硬化腹水形成与肾脏的关系的复习,提出肝硬化腹水中利尿剂的合理应用。一、腹水形成学说腹水形成主要有两种学说,一是传统途径,认为由于门脉高压,胶体渗透压降低和肝淋巴液漏出增多等综合因素引起腹水。由于循环血浆容量丧失,导致血管收缩,从而向肾小管发出潴盐信号,故尿钠潴留乃由于腹水形成导致血容量缩减,即血管充
In the treatment of cirrhosis and ascites, the rational use of diuretics is based on a full understanding of the pathophysiology of ascites and the mechanism of action on diuretics. This article through the review of the relationship between the formation of cirrhosis and ascites and renal, put forward the reasonable application of diuretics in cirrhosis and ascites. First, the formation of ascites Aspheric formation There are two main theories, one is the traditional way, that as a result of portal hypertension, colloid osmotic pressure decreased and increased leakage of liver lymphatic and other factors caused by ascites. As the loss of circulating plasma volume, leading to vasoconstriction, which issued to the renal tubular retention of salt signal, so retention of urine sodium is due to the formation of ascites resulting in reduced blood volume, that is filled with blood vessels