How to drain ascites
Ascites refers to the abnormal accumulation of fluid in the abdominal cavity, which is common in diseases such as cirrhosis, heart failure, and malignant tumors. Draining ascites (abdominal paracentesis) is a common treatment used to relieve uncomfortable symptoms in patients. This article will introduce in detail the steps, precautions and related data of ascites extraction.
1. Indications and contraindications for ascites extraction
Ascites aspiration is not suitable for all patients with ascites. The following are common indications and contraindications:
| Indications | Contraindications |
|---|---|
| Large amounts of ascites causing difficulty breathing | coagulopathy |
| Ascites infection (eg, spontaneous bacterial peritonitis) | severe thrombocytopenia |
| Diagnostic puncture (to determine the cause of ascites) | Intestinal obstruction or abdominal adhesions |
2. Steps to pump ascites
Ascites extraction must be performed under sterile conditions and is usually performed by professional medical staff. Here are the main steps:
| steps | Specific operations |
|---|---|
| 1. Preparation before surgery | The patient urinates in a semi-recumbent or side-lying position; disinfect the puncture site (usually the left or right lower abdomen) |
| 2. Local anesthesia | Local anesthesia using lidocaine |
| 3. Puncture | Slowly insert the puncture needle into the abdominal cavity and extract the ascites. |
| 4. Postoperative treatment | Pull out the puncture needle and bandage the puncture point with pressure; send ascites sample for examination |
3. Precautions for pumping ascites
Although ascites is a common operation, you still need to pay attention to the following things:
| Things to note | Description |
|---|---|
| Single pumping volume | Generally no more than 1000-1500ml to avoid sudden drop in abdominal pressure |
| Postoperative monitoring | Observe blood pressure, heart rate and whether there is any leakage at the puncture point |
| Complication prevention | Be alert to complications such as infection, bleeding, and hypotension |
4. Laboratory test indicators of ascites
The aspirated ascites needs to be sent to the laboratory for examination. The following are some key indicators:
| indicator | normal range | clinical significance |
|---|---|---|
| white blood cell count | <500/μL | Elevated levels suggest infection |
| Albumin | 1.1-2.5g/dL | Used to calculate SAAG (serum-ascites albumin gradient) |
| total protein | <2.5g/dL | Elevated levels may indicate malignancy or tuberculosis |
5. Care and treatment after ascites extraction
After ascites is removed, treatment and care must be taken based on the cause:
| measures | Specific content |
|---|---|
| diet modification | Low-salt diet (daily sodium intake <2g) |
| drug treatment | Diuretics (such as spironolactone, furosemide) |
| Regular review | Monitor the recurrence of ascites and liver function |
6. Latest research progress
According to recent medical research, there are the following new developments in the field of ascites treatment:
| Research direction | Latest findings |
|---|---|
| New diuretics | Tolvaptan is effective in treating refractory ascites |
| minimally invasive techniques | Abdominal tube drainage reduces repeated punctures |
| stem cell therapy | Clinical trial shows possible improvement in cirrhosis and ascites |
Ascites extraction is a technique that requires strict indications and operating specifications. Patients should undergo treatment under the guidance of a doctor and cooperate with long-term management to improve their quality of life.
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