Liver diseases can lead to repeating inflammation. If the inflammation is not treated in time, liver cirrhosis can cause many clinicopathologic factors, such as portal hypertension, hypoproteinemia and sodium retention. All those clinicopathologic factors finally induce ascites. Liver cirrhosis ascites is not a single disease, but a common clinical manifestation of many liver diseases in late stage. Hepatitis B, hepatitis C and alcoholic hepatitis are common causes of liver cirrhosis ascites. When liver diseases come to the liver cirrhosis ascites stage, it is a sign that liver cirrhosis is in late stage. If patients do not treat properly, the prognosis is bad. Generally speaking, the following are treatments of ascites:
General Treatment: it includes rest in bed, water and Na intake limit. The daily intake of Na should be 250～500mg. Once the ascites has the sign of relief, the daily intake of Na intake can increase to 1000～2000mg. Commonly the daily intake of water should be limited into 1500ml.
Ureic Treatment:it is better to lose less than 0.5 kg weight by ureic treatment. The ureic treatment can avoid hepatic encephalopathy and hepatorenal syndrome.
Albumin Injection: it is used to treat refractory ascites. Patients should also do large-volume paracentesis, 4000～6000 ml every time. Meanwhile, the albumin injection should be 40g.
Increase Plasma Oncotic Pressure:patients should inject albumin or blood plasma regularly.
Ascites Reinfusion:it is used to treatment refractory ascites, hypovolemic, hyponatremia, hypoproteinemia and hepatorenal syndrome. But patients with the following symptoms cannot use ascites reinfusion treatment: infectious ascites, intraperitoneal chenmotherapy and Endogenous endotoxin ascites.
TIPS:transjugular intrahepatic portosystemic shunt (TIPS) can effectively decrease portal pressure. Besides, TIPS has advantages of small trauma and high security. TIPS is often used to treat refectory ascites and esophageal varices massive hemorrhage. But it is likely to induce hepatic encephalopathy.
Refractory ascites is also called intractable ascites. It refers to a kind of ascites condition that after liver cirrhosis patients receive ureic treatment, there is still no obvious improvement or even aggravation
In recent years, it is thought that terlipressin and protein injection work well in intractable ascites treatment. But the expensive treatment fees limit the application. Liver transplantation is essential treatment of liver cirrhosis in late stage. Liver cirrhosis patients should do liver transplantation operation as soon as possible when the intractable ascites is controlled well.