消化指南

订阅

MedSci主页 / 所有栏目 / 消化指南

AASLD成人肝硬化腹水治疗指南2012年修订版

2013-04-08 美国肝病研究学会 Hepatology.2013,57(4):1651-1653

肝硬化

译文请见>>2012年AASLD成人肝硬化腹水处理指南更新版(译文)腹水是肝硬化三大并发症中最常见的，其他并发症包括肝性脑病、静脉曲张出血。腹水的发展可能是出现肝硬化最初始的证据。肥胖使体检对筛查腹水少有帮助。对患者有效的护理可以减少这些人再次入院的频率。本指南是第四版，对2009版进行了彻底更新。在这次修订中，治疗的选择分为一线，二线，三线，以及实验性方案。有一些新的药物应避免或谨慎

中文标题：

AASLD成人肝硬化腹水治疗指南2012年修订版

英文标题：

Introduction to the revised American Association for the Study of Liver Diseases Practice Guideline management of adult patients with ascites due to cirrhosis 2012

发布机构：

美国肝病研究学会

发布日期：

2013-04-08

简要介绍：

译文请见>>2012年AASLD成人肝硬化腹水处理指南更新版(译文)腹水是肝硬化三大并发症中最常见的，其他并发症包括肝性脑病、静脉曲张出血。腹水的发展可能是出现肝硬化最初始的证据。肥胖使体检对筛查腹水少有帮助。对患者有效的护理可以减少这些人再次入院的频率。本指南是第四版，对2009版进行了彻底更新。在这次修订中，治疗的选择分为一线，二线，三线，以及实验性方案。有一些新的药物应避免或谨慎使用。降低血压可能影响生存。血管紧张素转换酶抑制剂和血管紧张素受体阻滞剂对于肝硬化腹水患者应避免使用或慎用。欧洲肝脏研究协会实践指南对腹水的建议”……他们一般不应用于腹水患者。”该修订指南强调了这一警告。当前，许多患者，特别是那些肥胖和非酒精性脂肪性肝炎（NASH）的患者，在失代偿前均有高血压。全身血压正常化可能是肝硬化的唯一“福利”。在血管紧张素转换酶抑制剂和血管紧张素受体拮抗剂的使用的情况下，血压和肾功能必须仔细监测，以避免肾功能衰竭的快速发展。普萘洛尔在一项前瞻性难治性腹水的研究中已证明能缩短患者的生存。有顽固性腹水患者，应密切监测血压和肾功能。必须对每一个病人仔细衡量β受体阻滞剂的风险与效益。针对那些顽固性腹水患者或出现严重低血压以及氮质血症加重的患者，应考虑停用β受体阻滞剂或初始不应用β受体阻滞剂。当前版本的指南中，也加入了新的部分，包括肝性胸水和蜂窝织炎。基于以往的和新的研究建议，在肝性胸水中不支持插入胸腔引流管，对肝硬化腹水患者禁用经皮内镜下胃造口术。


相关资料下载：
[AttachmentFileName(sort=100, fileName=AASLD成人肝硬化腹水治疗指南2012年修订版)] GetToolGuiderByIdResponse(projectId=1, id=6c7fb1c0009e57b4, title=AASLD成人肝硬化腹水治疗指南2012年修订版, enTitle=Introduction to the revised American Association for the Study of Liver Diseases Practice Guideline management of adult patients with ascites due to cirrhosis 2012, guiderFrom=Hepatology.2013,57(4):1651-1653, authorId=null, author=, summary=译文请见&gt;&gt;2012年AASLD成人肝硬化腹水处理指南更新版(译文)腹水是肝硬化三大并发症中最常见的，其他并发症包括肝性脑病、静脉曲张出血。腹水的发展可能是出现肝硬化最初始的证据。肥胖使体检对筛查腹水少有帮助。对患者有效的护理可以减少这些人再次入院的频率。本指南是第四版，对2009版进行了彻底更新。在这次修订中，治疗的选择分为一线，二线，三线，以及实验性方案。有一些新的药物应避免或谨慎, cover=, journalId=null, articlesId=null, associationId=65, associationName=美国肝病研究学会, associationIntro=美国肝病学会于1950年3月在伊利诺斯州美国肝病学会正式成立。目前已经拥有2,700多名的专家会员和研究员，成为致力于肝病研究和学术交流最为重要的国际性学术组织。 该学会除了每年11月左右举行的一年一度的年会外，还联合美国胃肠病协会（AGA， American Gastroenterological Association ）、美国胃肠内镜学会（ASGE ， American Society for Gastrointestinal Endoscopy） 和消化外科学会（SSAT， Society for Surgery of the Alimentary Tract）每年举行一次&ldquo;消化疾病周&rdquo;学术交流会。该学会拥有HEPATOLOGY和Liver Transplantation两本影响力非常大的专业杂志。, copyright=0, guiderPublishedTime=Mon Apr 08 08:00:00 CST 2013, originalUrl=http://guide.medlive.cn/guideline/4386, linkOutUrl=, content=译文请见>>2012年AASLD成人肝硬化腹水处理指南更新版(译文)腹水是肝硬化三大并发症中最常见的，其他并发症包括肝性脑病、静脉曲张出血。腹水的发展可能是出现肝硬化最初始的证据。肥胖使体检对筛查腹水少有帮助。对患者有效的护理可以减少这些人再次入院的频率。本指南是第四版，对2009版进行了彻底更新。在这次修订中，治疗的选择分为一线，二线，三线，以及实验性方案。有一些新的药物应避免或谨慎使用。降低血压可能影响生存。血管紧张素转换酶抑制剂和血管紧张素受体阻滞剂对于肝硬化腹水患者应避免使用或慎用。欧洲肝脏研究协会实践指南对腹水的建议”……他们一般不应用于腹水患者。”该修订指南强调了这一警告。当前，许多患者，特别是那些肥胖和非酒精性脂肪性肝炎（NASH）的患者，在失代偿前均有高血压。全身血压正常化可能是肝硬化的唯一“福利”。在血管紧张素转换酶抑制剂和血管紧张素受体拮抗剂的使用的情况下，血压和肾功能必须仔细监测，以避免肾功能衰竭的快速发展。普萘洛尔在一项前瞻性难治性腹水的研究中已证明能缩短患者的生存。有顽固性腹水患者，应密切监测血压和肾功能。必须对每一个病人仔细衡量β受体阻滞剂的风险与效益。针对那些顽固性腹水患者或出现严重低血压以及氮质血症加重的患者，应考虑停用β受体阻滞剂或初始不应用β受体阻滞剂。当前版本的指南中，也加入了新的部分，包括肝性胸水和蜂窝织炎。基于以往的和新的研究建议，在肝性胸水中不支持插入胸腔引流管，对肝硬化腹水患者禁用经皮内镜下胃造口术。<div><br></div>, tagList=[TagDto(tagId=492, tagName=肝硬化)], categoryList=[CategoryDto(categoryId=4, categoryName=消化, tenant=100), CategoryDto(categoryId=22, categoryName=肝病, tenant=100), CategoryDto(categoryId=21100, categoryName=达仁堂循证e学界, tenant=100)], articleKeywordId=null, articleKeyword=null, articleKeywordNum=null, guiderKeywordId=null, guiderKeyword=null, guiderKeywordNum=null, haveAttachments=1, attachmentList=null, guiderType=0, guiderArea=指南, guiderLanguage=0, guiderRegion=0, opened=0, paymentType=null, paymentAmount=10, recommend=0, recommendEndTime=null, sticky=0, stickyEndTime=null, allHits=3301, appHits=169, showAppHits=7, pcHits=2144, showPcHits=1208, likes=167, shares=7, comments=8, approvalStatus=1, publishedTime=Mon Apr 08 00:00:00 CST 2013, publishedTimeString=2013-04-08, pcVisible=1, appVisible=1, editorId=4754896, editor=fbzhang, waterMark=0, formatted=0, memberCards=[], isPrivilege=0, deleted=0, version=1, createdBy=null, createdName=fbzhang, createdTime=Mon Apr 08 00:00:00 CST 2013, updatedBy=null, updatedName=null, updatedTime=Wed Jan 03 07:59:13 CST 2024, courseDetails=[], otherVersionGuiders=[], isGuiderMember=false, ipAttribution=, attachmentFileNameList=[AttachmentFileName(sort=100, fileName=AASLD成人肝硬化腹水治疗指南2012年修订版)])
AASLD成人肝硬化腹水治疗指南2012年修订版
下载请点击：
评论区 (8)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1061961, encodeId=fe991061961f4, content=非常好的文章，受益匪浅。, beContent=null, objectType=guider, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6c905475903, createdName=湘雅科教, createdTime=Tue Oct 19 16:57:57 CST 2021, time=2021-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1061934, encodeId=22d4106193448, content=非常好的文章，受益匪浅。, beContent=null, objectType=guider, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6c905475903, createdName=湘雅科教, createdTime=Tue Oct 19 16:53:23 CST 2021, time=2021-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1061930, encodeId=91491061930e1, content=非常好的文章，受益匪浅。, beContent=null, objectType=guider, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6c905475903, createdName=湘雅科教, createdTime=Tue Oct 19 16:52:31 CST 2021, time=2021-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1061925, encodeId=984c1061925be, content=非常好的文章，受益匪浅。, beContent=null, objectType=guider, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6c905475903, createdName=湘雅科教, createdTime=Tue Oct 19 16:51:38 CST 2021, time=2021-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1061923, encodeId=123510619236a, content=非常好的文章，受益匪浅。, beContent=null, objectType=guider, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6c905475903, createdName=湘雅科教, createdTime=Tue Oct 19 16:51:12 CST 2021, time=2021-10-19, status=1, ipAttribution=)]
    2021-10-19 湘雅科教

    非常好的文章，受益匪浅。

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1061961, encodeId=fe991061961f4, content=非常好的文章，受益匪浅。, beContent=null, objectType=guider, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6c905475903, createdName=湘雅科教, createdTime=Tue Oct 19 16:57:57 CST 2021, time=2021-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1061934, encodeId=22d4106193448, content=非常好的文章，受益匪浅。, beContent=null, objectType=guider, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6c905475903, createdName=湘雅科教, createdTime=Tue Oct 19 16:53:23 CST 2021, time=2021-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1061930, encodeId=91491061930e1, content=非常好的文章，受益匪浅。, beContent=null, objectType=guider, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6c905475903, createdName=湘雅科教, createdTime=Tue Oct 19 16:52:31 CST 2021, time=2021-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1061925, encodeId=984c1061925be, content=非常好的文章，受益匪浅。, beContent=null, objectType=guider, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6c905475903, createdName=湘雅科教, createdTime=Tue Oct 19 16:51:38 CST 2021, time=2021-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1061923, encodeId=123510619236a, content=非常好的文章，受益匪浅。, beContent=null, objectType=guider, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6c905475903, createdName=湘雅科教, createdTime=Tue Oct 19 16:51:12 CST 2021, time=2021-10-19, status=1, ipAttribution=)]
    2021-10-19 湘雅科教

    非常好的文章，受益匪浅。

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1061961, encodeId=fe991061961f4, content=非常好的文章，受益匪浅。, beContent=null, objectType=guider, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6c905475903, createdName=湘雅科教, createdTime=Tue Oct 19 16:57:57 CST 2021, time=2021-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1061934, encodeId=22d4106193448, content=非常好的文章，受益匪浅。, beContent=null, objectType=guider, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6c905475903, createdName=湘雅科教, createdTime=Tue Oct 19 16:53:23 CST 2021, time=2021-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1061930, encodeId=91491061930e1, content=非常好的文章，受益匪浅。, beContent=null, objectType=guider, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6c905475903, createdName=湘雅科教, createdTime=Tue Oct 19 16:52:31 CST 2021, time=2021-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1061925, encodeId=984c1061925be, content=非常好的文章，受益匪浅。, beContent=null, objectType=guider, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6c905475903, createdName=湘雅科教, createdTime=Tue Oct 19 16:51:38 CST 2021, time=2021-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1061923, encodeId=123510619236a, content=非常好的文章，受益匪浅。, beContent=null, objectType=guider, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6c905475903, createdName=湘雅科教, createdTime=Tue Oct 19 16:51:12 CST 2021, time=2021-10-19, status=1, ipAttribution=)]
    2021-10-19 湘雅科教

    非常好的文章，受益匪浅。

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1061961, encodeId=fe991061961f4, content=非常好的文章，受益匪浅。, beContent=null, objectType=guider, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6c905475903, createdName=湘雅科教, createdTime=Tue Oct 19 16:57:57 CST 2021, time=2021-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1061934, encodeId=22d4106193448, content=非常好的文章，受益匪浅。, beContent=null, objectType=guider, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6c905475903, createdName=湘雅科教, createdTime=Tue Oct 19 16:53:23 CST 2021, time=2021-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1061930, encodeId=91491061930e1, content=非常好的文章，受益匪浅。, beContent=null, objectType=guider, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6c905475903, createdName=湘雅科教, createdTime=Tue Oct 19 16:52:31 CST 2021, time=2021-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1061925, encodeId=984c1061925be, content=非常好的文章，受益匪浅。, beContent=null, objectType=guider, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6c905475903, createdName=湘雅科教, createdTime=Tue Oct 19 16:51:38 CST 2021, time=2021-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1061923, encodeId=123510619236a, content=非常好的文章，受益匪浅。, beContent=null, objectType=guider, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6c905475903, createdName=湘雅科教, createdTime=Tue Oct 19 16:51:12 CST 2021, time=2021-10-19, status=1, ipAttribution=)]
    2021-10-19 湘雅科教

    非常好的文章，受益匪浅。

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1061961, encodeId=fe991061961f4, content=非常好的文章，受益匪浅。, beContent=null, objectType=guider, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6c905475903, createdName=湘雅科教, createdTime=Tue Oct 19 16:57:57 CST 2021, time=2021-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1061934, encodeId=22d4106193448, content=非常好的文章，受益匪浅。, beContent=null, objectType=guider, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6c905475903, createdName=湘雅科教, createdTime=Tue Oct 19 16:53:23 CST 2021, time=2021-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1061930, encodeId=91491061930e1, content=非常好的文章，受益匪浅。, beContent=null, objectType=guider, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6c905475903, createdName=湘雅科教, createdTime=Tue Oct 19 16:52:31 CST 2021, time=2021-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1061925, encodeId=984c1061925be, content=非常好的文章，受益匪浅。, beContent=null, objectType=guider, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6c905475903, createdName=湘雅科教, createdTime=Tue Oct 19 16:51:38 CST 2021, time=2021-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1061923, encodeId=123510619236a, content=非常好的文章，受益匪浅。, beContent=null, objectType=guider, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6c905475903, createdName=湘雅科教, createdTime=Tue Oct 19 16:51:12 CST 2021, time=2021-10-19, status=1, ipAttribution=)]
    2021-10-19 湘雅科教

    非常好的文章，受益匪浅。

    0