Do you know the symptoms and treatment of liver ascites

In life, some friends do not have enough knowledge about the disease of ascites, so they are afraid of it. In fact, ascites is not terrible. In the early stages, it can be treated with a low-salt diet. Everyone can learn more about the symptoms of the disease, and patients can relax and receive treatment.

Typical symptoms of hepatic ascites

1. Enlarged or shrunken liver: Cirrhosis ascites, especially ascites caused by alcoholic cirrhosis, is often accompanied by enlarged liver, which may shrink in the late stage. In liver cancer, the liver is enlarged and hard as a stone, and the surface may be nodular. When there is acute hepatic vein obstruction, there may be sudden progressive hepatomegaly and rapid growth of cirrhosis ascites.

2. Symptoms of ascites due to cirrhosis accompanied by jaundice, hematemesis, and black stools: Ascites is more common in cirrhosis, liver cancer, and other gastrointestinal tumors. Hematemesis and black stools are typical manifestations of upper gastrointestinal bleeding.

3. Chills, fever, abdominal pain, abdominal muscle tension and tenderness: mostly indicate peritonitis caused by various reasons; in acute peritonitis, the abdominal muscles are tense, there is tenderness and rebound pain, and abdominal breathing may weaken or disappear due to pain or abdominal muscle tension.

treat

1. General treatment: including bed rest and limiting water and sodium intake. The daily sodium intake is 250-500 mg. If the urinary sodium is between 10 and 50 mmol/24h, it means that the sodium retention is not very serious. The daily sodium intake is 500 to 1000 mg, that is, 1200 to 2400 mg of sodium chloride, which is equivalent to a low-salt diet. Once obvious diuresis occurs or ascites subsides, sodium intake can be increased by 1000 to 2000 mg per day. Generally, daily water intake should be limited to 1500 ml. If serum sodium is less than 130 mmol/L, daily water intake should be controlled below 1000 ml. If serum sodium is less than 125 mmol/L, daily water intake should be reduced to 500 ml to 700 ml.

2. Diuretic treatment: such as hydrochlorothiazide, 25-100 mg each time, taken every other day or 1-2 times a week. Amiloride, 50-100 mg per day, taken after meals. The main drugs used are spironolactone and furosemide. The ratio of spironolactone and furosemide used was 100 mg:40 mg. The patient was started with spironolactone 100 mg/day and furosemide 40 mg/day. If the diuretic effect is not obvious, the dosage can be gradually increased. Diuretic treatment should limit weight loss to no more than 0.5 kg per day to avoid inducing hepatic encephalopathy and hepatorenal syndrome. If the ascites gradually subsides, the dose of diuretics can be gradually reduced.

3. Repeated large-volume ascites drainage plus intravenous albumin infusion: used to treat refractory ascites. Ascites was drained daily or three times a week, 4000-6000 ml each time, and 40 g of albumin was infused intravenously.