Indications for ascites retransfusion in the treatment of cirrhotic ascites.
The indications are: intractable ascites in cirrhosis, such as hepatorenal syndrome; respiratory distress due to large amounts of ascites; failure to lose weight after two weeks of low-salt diet; inability to adhere to regular medical therapy; repeated hospitalization of patients, etc.
Patients should be examined before performing ascites retransfusion.
The following items should be routinely checked before performing ascites retransfusion for patients with cirrhosis; routine blood, urine, stool and occult blood; platelet count and bleeding and coagulation; liver function tests (including serum bilirubin, transaminases, albumin, etc.); blood potassium and urea nitrogen, cholesterol; prothrombin time and prothrombin percentage; liver and biliary ultrasound: electrocardiogram, etc.
Contraindications to ascites retransfusion for the treatment of cirrhotic ascites.
The contraindications are.
(1) Heavy hepatitis, total blood bilirubin 171 μmol/L.
(2) Those with significant bleeding tendency in the short term.
(3) Hepatic encephalopathy II or higher.
(4) Those with primary peritonitis with uncontrolled exudative ascites
(5) those with severe cardiac and pulmonary insufficiency
(6) hemorrhagic ascites, suspected tumor or tuberculosis
(7) Those who have had recent upper gastrointestinal hemorrhage.
The common adverse effects of ascites transfusion for cirrhotic ascites are:
(1) fever.
(2) Diffuse intravascular NE blood (DIC);
(3) Anaphylaxis.
(4) Upper gastrointestinal bleeding.
(5) Hepatic encephalopathy.
(6) Electrolyte disorders.
Precautions for ascitic fluid reinfusion in the treatment of cirrhotic ascites.
The precautions are:
(1) The rate of transfusion should not be too fast.
(2) Closely observe the changes of respiration, pulse, blood pressure and cardiopulmonary function of the patient.
(3) Strict implementation of aseptic technique and preoperative administration of dexamethasone and other drugs.
(4) Postoperative observation of changes in the patient’s blood biochemical indexes should be paid attention to, and problems found should be dealt with in a timely manner.
(5) Appropriate use of antibiotics to prevent secondary infection.
(6) Oral lactulose to reduce the absorption of ammonia and other toxic substances to prevent the occurrence of hepatic encephalopathy.