Xiao Liu loves to drink, but he is not fat, but his abdomen is bulging year by year, and his friends all laughed and said: You are about to give birth! Xiao Liu laughed and ignored it; until recently, his wife found that Xiao Liu’s abdomen was so big that even his navel was bulging, and he had a lack of appetite. Not only did he eat less, but he also often felt sick and wanted to vomit , Only then did I feel that this big belly may not be a good thing!

The average person will have some body fluids in the abdominal cavity to lubricate the organs, but when too much fluid accumulates in the abdominal cavity, ascites will form, and then things will be bad. Can ascites be pumped? How to draw?

A common cause of ascites is cirrhosis of the liver

The causes of ascites can be divided into ascites caused by liver cirrhosis and pathological ascites caused by non-cirrhotic causes. Liver cirrhosis can cause ascites, because after liver cirrhosis, the resistance of blood flow into the portal vein increases, resulting in hepatic portal hypertension, and the systemic vasodilator substances will increase, causing the tiny arteries at the end of the kidney to expand, renin-angiotensin ─After the aldosterone system is activated, it strengthens the function of retaining salt and water in the renal tubules, resulting in excessive body water;

On the other hand, portal hypertension can also increase the pressure of small blood vessels in the abdominal cavity, causing water to easily extravasate and form ascites.

The liver of patients with severe liver cirrhosis is unable to produce albumin smoothly, resulting in too low albumin in the blood. The main function of albumin in the blood is to maintain the osmotic pressure of the blood, which can retain water in the blood vessels. Once it is too low, the osmotic pressure in the blood vessels will drop, allowing the water in the blood vessels to extravasate and accumulate in the peritoneal cavity. ascites.

Not ascites caused by liver cirrhosis, common diseases such as heart failure, albumin loss caused by nephrotic syndrome, or inflammatory infections in the body, such as pancreatitis and peritonitis, may cause ascites;

In addition, any metastatic or primary cancer can also cause ascites.

There are obvious symptoms in the early stage of ascites, and pathological examination and abdominal ultrasound can confirm the diagnosis

When the amount of ascites in the body exceeds 500 ml, the patient will begin to feel abdominal distension. With the increase of the amount of water, the organs in the abdominal cavity will be compressed, resulting in decreased appetite and poor appetite. Some patients will have poor intestinal peristalsis due to malignant ascites. , and even paralytic intestinal obstruction, resulting in vomiting symptoms.

Even because the tumor compresses blood vessels and affects the systemic vascular circulation, it may cause edema of the lower extremities.

When a patient is suspected of having ascites, clinically, the patient’s navel will be observed to see if there is a bulging phenomenon, and when a pathological examination is performed, a percussion method will be used to find out whether there is dullness. Generally speaking, if there is ascites, an interface between fluid and intestinal gas will be formed in the patient’s abdomen. When tapped with a finger, the sound of the gas part will be a louder drum sound; if there is water, the sound will be duller. , such as voiced sound.

During the examination, the patient is asked to lie down and tap the interface to hear the sound; then, the patient is turned sideways, the interface will change, and the examiner will judge whether the patient has accumulated ascites based on the mobile dullness. Using an abdominal ultrasound can also help determine the presence and amount of ascites.

If there is ascites, the cause should be identified as soon as possible

There is ascites in the stomach, and the cause must be found out and treated to improve the situation of ascites. If it is caused by a malignant tumor, the primary location of the tumor should also be found and treated. If it is caused by an infection, the possible pathogenic bacteria (such as bacteria, fungi or tuberculosis) should be treated with appropriate drugs to achieve infection control. Target.

In order to diagnose the cause, a small amount of ascites is sometimes drawn for testing. Generally, about 20-25 ml of ascites is drawn for testing (depending on the number of test items), and through the examination of ascites, such as blood cell classification, biochemistry, cytology, bacteria or mold culture, the The nature and possible causes of ascites can be further distinguished.

Ascites requires salt restriction, water restriction, and diuretics

Once there is ascites, it is necessary to avoid eating foods or beverages with high sodium content, such as pickled foods, processed canned foods, sports drinks, etc., because salt can easily lead to the retention of water in the body , it is generally recommended that the sodium intake should not exceed 3.5 grams a day . Choose unprocessed, fresh foods.

More serious patients should also control the intake of water, preferably within 1000-1500 ml a day. If ascites cannot be controlled on a low-salt diet, diuretics may be considered. It should be reminded that patients using diuretics should measure and record their body weight at a fixed time every day, and should not exceed 0.5 kg a day to avoid rapid deterioration of renal function caused by a large amount of dehydration.

Pumping ascites can only treat the symptoms, and the amount of ascites is limited

If there is too much ascites, the patient is extremely uncomfortable. If necessary, ascites can be pumped to relieve symptoms, but the amount of ascites is limited to 4-6 liters a day . Renal function, when a large amount of ascites is withdrawn, albumin is usually supplemented to maintain circulation stability.

Before drawing ascites, it is also necessary to confirm whether the patient has any contraindications to drawing ascites, such as whether there is local infection of the skin, whether there is a systemic abnormal coagulation function, etc., so as to avoid intra-abdominal infection or bleeding when drawing ascites.

In the early stage of ascites, in addition to diet control, traditional medicine can also be considered for treatment, but it is not a blind medicine or a prescription. Methods , for example, ascites caused by liver cirrhosis can generally include: damp-heat, qi stagnation, blood stasis, cold-dampness, liver-kidney yang deficiency, spleen-kidney yang deficiency, lung yang deficiency, etc. Yin Chenhao Soup, Longdan Xiegan Soup, etc.

Therefore, once you find ascites, don’t go to the doctor indiscriminately, especially if one side or one medicine can solve it, choose carefully.

How to pump ascites?

When pumping ascites, the doctor disinfects the patient’s skin locally and injects a local anesthetic, and then uses ultrasound to find a suitable position for needle insertion. When necessary, the patient will be asked to lie on his side. Due to the principle of gravity, the ascites will accumulate below, which is convenient for extraction. The extraction site is usually selected away from the intestines and keeps a safe distance and range from other organs.

But what needs to be understood is that pumping ascites can only cure the symptoms, not the root cause.

There are five clinical assessments of the severity of liver cirrhosis, including the presence or absence of hepatic encephalopathy, total jaundice index, albumin, coagulation function and ascites. It is not always certain when patients with liver cirrhosis will develop ascites, but when the patient has already developed ascites, it generally has entered the decompensated stage. If the disease problem is not resolved in such patients with severe liver cirrhosis, the ascites will be extracted within a few days. Days later, there may still be a steady stream of appearances.

One treatment modality is the placement of a stent between the hepatic vein and the portal vein, known as a transjugular intrahepatic portosystemic stent shunt, which reduces portal hypertension and improves ascites, but usually increases the severity of hepatic encephalopathy. At this time, the only choice is liver transplantation, and then there is a chance to get rid of the life of repeated ascites extraction.

When a patient needs to pump ascites, can it be pumped at home?

Generally, it is not recommended for patients to pump ascites at home. The first is that it is best to have B-ultrasound guidance for pumping ascites, and the other is that infection is easy to occur outside the hospital.

However, some patients are wheezing due to a large amount of ascites and have difficulty moving. If the frequency of ascites extraction is high and it is very necessary to pump ascites at home, some medical institutions can provide portable ultrasound services, so that the service of ascites extraction can be performed by medical staff in person. In case of danger, it can also be dealt with urgently.