복수를 동반한 간경변증 환자에서 대량복수천자가 혈장량에 미치는 영향 = Effects of Large Volume Paracentesis복수를 동반한 간경변증 환자에서 대량복수천자가 혈장량에 미치는 영향

다국어 초록 (Multilingual Abstract)

Large volume paracentesis (LVP) has been avoided because of complications such as intravascular volume depletion, renal insufficiency, portosystemic encephalopathy, and hepatic failure. But recent studies showed that systemic hemodynamics were not adversely affected during the 24hr following LVP. In this study, 6 edematous patients with liver cirrhosis and tense ascites underwent large volume paracentesis (3 liter). Plasma volume was measured by a dilution method with 125I-labeled human serum albumin prior to and at 24 hours after the LVP. And serum sodium, creatinine, blood urea nitrogen, and hematocrit were also measured prior to and at 24 hours and 48 hours after the LVP. The results were as follows. 1) All patients felt better after paracentesis and no hypotension, tachycardia, and encephalopathy occurred. 2) Mean plasma volume was 3381±127ml preparacentesis and 3340±116ml postparacentesis (p<0.1). 3) There was no change in serum sodium, creatinine or blood urea nitrogen and hematocrit during the 48 hours following LVP. 4) Urine volume tended to increase during the 24 hours after LVP. We concluded that 3 liter paracentesis in cirrhotic patient with tense ascites and peripheral edema is not associated with a decrease in plasma volume at 24 hours after the paracentesis and expected complications such as renal insufficiency and encephalopathy did not occur.