Ascites,Peritoneal cavity,Peritoneal fluid,Etiology of ascites 腹水，腹膜腔，腹水，腹水的病因.ppt

下载文档 降价啦

2
0
约1.37万字
约 69页
2017-09-04 发布于江西
举报
版权申诉
保障服务

Ascites,Peritoneal cavity,Peritoneal fluid,Etiology of ascites 腹水，腹膜腔，腹水，腹水的病因.ppt

1、本文档共69页，可阅读全部内容。
2、原创力文档（book118）网站文档一经付费（服务费），不意味着购买了该文档的版权，仅供个人/单位学习、研究之用，不得用于商业用途，未经授权，严禁复制、发行、汇编、翻译或者网络传播等，侵权必究。
3、本站所有内容均由合作方或网友上传，本站不对文档的完整性、权威性及其观点立场正确性做任何保证或承诺！文档内容仅供研究参考，付费前请自行鉴别。如您付费，意味着您自己接受本站规则且自行承担风险，本站不退款、不进行额外附加服务；查看《如何避免下载的几个坑》。如果您已付费下载过本站文档，您可以点击这里二次下载。
4、如文档侵犯商业秘密、侵犯著作权、侵犯人身权等，请点击“版权申诉”（推荐），也可以打举报电话：400-050-0827(电话支持时间：9:00-18:30)。

Ascites,Peritoneal cavity,Peritoneal fluid,Etiology of ascites 腹水，腹膜腔，腹水，腹水的病因

Type 1 HRS: Doubling of initial serum creatinine level to 205mg/dl or a 50% cause decreasing in 24-hour creatinine clearance to 20ml/min in 2 weeks. Mortality is 90% without liver transplantation. Type 2 HRS: RF has a slower progressive course. Occur in the setting of chronic or acute liver disease with portal hypertension. Low GFR (with creatinine 1.5mg/dl) No evidence of shock, bacterial infection, or treatment with nephrotoxic agents + absence of GI fluid losses or renal fluid losses. No improvement in renal function following diuretic withdrawal. Proteinuria 500mg/dl and no US evidence of renal disease or obstructive uropathy. Treatment of hepatorenal syndrome: Supportive Liver transplantation: Tx of Choice. It corrects both liver and kidney disease. Is associated with up to 60% survival rate in 3 years. Shortage of donor organs leads to a high rate of death in these patients. Complications of Ascites 3- Spontaneous Bacterial Peritonits 20% of patients with cirrhotic ascites Diagnosed with neutrophil count of 250/mm3 Gram – neg organisms in 60% of cases (E.coli and Klebsiella pneumoniae ) Gram + organisms 25% of cases (Strep species ) Symptoms: Abdominal pain, fever, development of hepatic encephalopathy, diarrhea, hypothermia and shock. Ascitic Protein level1 g/dl is a risk for Spontaneous Bacterial Peritonits. Treatment: Cefotaxime sodium References Scincedirect Uptodate eMedicine Health MedicineN Family Practice N Thank you Serum-Ascites Albumin Gradient Best single test for classifying ascites into portal hypertensive and non-portal hypertensive causes. Calculated by: Serum albumin – Ascites albumin= SAAG SAAG 1.1 g/dL= Portal HTN SAAG 1.1 g/dL= Non-Portal hypertensive cause SAAG SAAG 1.1 Liver Disease Hepatic Congestion CHF Tricuspid Insufficiency Massive Hepatic Metastasis SAAG 1.1 Peritoneal carcinomatosis Peritoneal Infection (TB, Fungal, CMV) Nephrotic syndrome Pancreatic ascites Total protein: Helpful in diagnosing spontane