Treatment of ascites in liver cirrhosis. AllOpecheniRu

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Published on Oct 6, 2022

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00:04 Ascites (abdominal dropsy) is an accumulation of non-inflammatory fluid in the abdominal cavity. Full text of the article on the website https://vseopecheni.ru/ via this link: https://vseopecheni.ru/liver/lechenie... 00:28 Increased pressure in the venous network, which leads to plasma leakage into the abdominal cavity. 01:28 Mild abdominal dropsy can only be diagnosed using instrumental research methods (ultrasound, MRI). 02:03 The pathogenesis of ascites in liver cirrhosis is multiple. The leading mechanism of dropsy in cirrhosis is portal hypertension. 02:28 Portal hypertension increases lymph production in the liver. 03:00 In this case, the process of fluid removal from the body is disrupted, which increases abdominal dropsy. 03:28 An exception is ascites in liver cirrhosis of cardiac origin, when the pathology occurs as a complication of heart failure. In such cases, stabilization of blood circulation is of paramount importance, since ascites is associated with compensatory deposition of blood plasma in severe heart failure. 04:00 Treatment of ascites in liver cirrhosis of viral origin includes antiviral therapy. 04:27 Treatment of ascites in cirrhosis begins with strict bed rest. This improves liver circulation, reduces the risk of complications, and facilitates the work of the heart. 05:30 Diet for cirrhosis of the liver with ascites. 05:58 It is necessary to limit protein intake when abdominal dropsy develops against the background of severe hepatocyte deficiency. 06:28 Patients are transferred to parenteral nutrition in critical cases, if there is a threat of developing hepatic coma. A week after the patient is brought out of a precoma, protein is gradually returned to the diet. 06:57 Treatment of liver cirrhosis with ascites — drugs Diuretics. 07:30 On the other hand, a decrease in fluid volume increases the concentration of toxic substances. Therefore, liver cirrhosis with ascites is treated with drugs with a diuretic effect under daily monitoring. 08:00 To increase the effectiveness of diuretics, the patient is administered plasma protein solutions intravenously. Complex treatment of ascites in liver cirrhosis includes detoxification therapy, normalization of the electrolyte ratio in the blood plasma, relief of polyhypovitaminosis and deficiency of macro- and microelements. 08:30 Therefore, with ascites, it is recommended to take hepatoprotectors - drugs that protect and restore liver cells. Not all hepatoprotectors have proven effectiveness. 08:57 Gastroenterologists and hepatologists mainly prescribe hepatoprotectors based on UDCA (Ursosan). 10:02 The increase in abdominal volume reduces the mobility of the chest and thus limits breathing. This leads to respiratory failure and threatens the development of congestive pneumonia. 10:32 Every second patient with therapy-resistant ascites dies within the first 6 months. Therefore, if it was possible to eliminate excess fluid, this is a favorable sign that gives hope for recovery.

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