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肝硬化腹水管理新策略——长期白蛋白治疗

  • 文蕾 ,
  • 俞慧宏 ,
  • 凌贤龙
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  • 1.重庆大学附属沙坪坝医院消化内科 (重庆 400030 )
    2.重庆医科大学附属第二医院消化内科 (重庆 400010 )
    3.陆军军医大学附属新桥医院消化内科 (重庆 400030 )
俞慧宏,重庆医科大学附属第二医院副主任医师、副教授、硕士生导师。重庆市医学会消化病学专委会青年委员会委员、重庆市中西医结合学会消化疾病专委会委员、重庆医科大学附属第二医院“宽仁英才-骨干人才”。2006年毕业于重庆医科大学,2012年获得重庆医科大学博士学位。曾在华西医院内镜中心进修半年,在美国俄勒冈大学培训3月。重庆市中西医结合学会消化疾病专委会委员、重医附二院核心师资。曾获得“优秀共产党员”及“优秀教师”称号。作为负责人主持国家自然科学基金1项,重庆市科委项目2项,作为主要骨干参与国家自然科学基金项目多项,已在国内外重要学术期刊发表论文10余篇,参编或副主编著作5本。

收稿日期: 2023-12-10

  网络出版日期: 2024-03-26

基金资助

第六批重庆市中青年医学高端人才计划资助项目

A new strategy for the management of ascites in liver cirrhosis: A long⁃term albumin treatment

  • lei WEN ,
  • Huihong YU ,
  • Xianlong LING
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  • Department of Gastroenterology,Shapingba Hospital,Chongqing University,hongqing 400030,China

Received date: 2023-12-10

  Online published: 2024-03-26

摘要

腹水是失代偿期肝硬化患者最常见的并发症,目前缺少有效的管理策略,导致腹水反复发生,甚至并发自发性腹膜炎、肝肾综合征、肝衰竭,增加病死率。白蛋白治疗肝硬化腹水由来已久,但通常局限于间断、短期治疗,相对而言,长期白蛋白治疗是一种全然不同的治疗观点,近期多项临床实验提示,对于部分肝硬化失代偿患者,足够剂量、足够时间的白蛋白治疗可能改善疾病病程。本文通过分析近期发表的长期白蛋白治疗的试验数据,探讨可能安全有效的治疗方案,包括最大获益人群、白蛋白剂量、时间、停药标准等,为临床工作提供参考。

本文引用格式

文蕾 , 俞慧宏 , 凌贤龙 . 肝硬化腹水管理新策略——长期白蛋白治疗[J]. 实用医学杂志, 2024 , 40(5) : 591 -595 . DOI: 10.3969/j.issn.1006-5725.2024.05.001

Abstract

Ascites is the most frequent decompensating event of cirrhosis. At present, ascites recurs at a high rate due to lack of effective management strategy and is frequently complicated with spontaneous bacterial peritonitis, hepatorenal syndrome, and liver failure, which increase the fatality rate. Albumin treatment for hepatocirrhosic ascites has a long history, but it is limited as an acute or short?term treatment. In contrast, long?term albumin administration represents a completely different treatment paradigm. Results from several recent clinical studies indicate that long?term albumin treatment can be able to modify the disease courses of some decompensated cirrhosis when albumin is given at a sufficient dose for a sufficient time. In this review, we analyze the available data acquired from long?term albumin treatments, trying to establish a secure and effective management scheme involving maximal target population, albumin dose, administration time, and standards for albumin withdrawal, and thus provide references for the clinical practice.

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