Comparison of intermittent drainage of ascites and diuretic therapy for cirrhosis patients with tense ascites

摘要

Objective: Ascites is one of the most frequent complications of cirrhosis. Our study is to investigate the efficacy and safety of the intermittent drainage of ascites for HBV-related cirrhosis patients with tense ascites. Material and methods: A total of 2,169 HBV-related, decompensated liver cirrhosis inpatients were screened from January 2009–January 2014. Of them, 112 cases were eligible, among whom 55 patients (treated group) were administered paracentesis with central venous catheter and drained of 1–2?L ascites every 1 or 2?days (PCVC therapy). The remaining 57 patients served as controls (control group). Results: Compared with the baseline, the level of mean arterial pressure (MAP) in the control group markedly declined (82.27?±?8.36?mm?Hg vs. 91.25?±?10.82?mm?Hg, p ?=?0.000), and the levels of MAP (79.14?±?10.30?mm Hg vs. 90.53?±?10.97?mm?Hg, p ?=?0.000) and hemoglobin (99.29?±?16.78?g/L vs. 107.55?±?21.80?g/L, p ?=?0.028) in the treated group dropped significantly. There were no significant differences in the levels of creatinine, sodium, eGFR, incidence of complications , weight loss, improvement rate, urine output and dosage of albumin between the two groups. The hospitalization time of the treated group was longer (21.49?±?13.34?days vs. 16.56?±?9.07?days, p ?=?0.025), and the amount of furosemide used in the treated group was greater than that used in the control group (47.72?±?18.53?mg vs. 27.99?±?13.32?mg, p ?=?0.000). Conclusions: Cirrhosis patients with tense ascites who received PCVC therapy showed decreased levels of Hb and MAP, but did not induce renal dysfunction. The efficacy of PCVC therapy is not superior to diuretic treatment.