A Clinical Analysis Of70Cases Of Cirrhosis Ascites Complicated By Electrolyte Disturbance In Beijing

BackgroundLiver Cirrhosis is a disease with the performance of a chronic and diffused damage of liver, and the most common complication of decompensated liver cirrhosis is ascites. Patients with liver cirrhosis ascites may be complicated by different kinds of electrolyte disturbance; some clinical researches have presented that there is a close relationship between electrolyte disturbance with other cirrhosis complications and the disease prognosis. Therefore, the prevention and redress of electrolyte disturbance show a great importance to the treatment of cirrhosis ascites.AimTo observe and discuss the clinical associations, curative effect and prognostic impact of electrolyte disturbance in cirrhosis ascites patients, and in order to provide the reference of the treatment of cirrhosis ascites.MethodCollected96cases of patients with liver cirrhosis ascites from2012-2013in a class3first level general hospital in Beijing. Serum electrolyte, hepatic/renal function and other serum indexes were obtained within24hours after hospitalization. Abdominal ultrasound (CT or MRI was taken if necessary) and gastroscope examination were completed within3-5days. All the patients were given protecting liver, albumin supplementation, adjusting the water and electrolyte balance, and other related treatments, serum electrolyte levels and functions of hepatic/renal were detected every other day. The therapeutic effect was evaluated by ultrasonography B (or the reduction of patient abdominal sac and weight); the complication and disease prognosis were analyzed before the patients were out of the hospital.Results(1)70electrolyte disturbance cases were found in all (72.92%); in which52cases were with mild to moderate electrolyte disturbance (74.29%) and18cases were with severe electrolyte disturbance (25.71%).(2) Comparing the patients with severe electrolyte disturbance and those without electrolyte disturbance, there were significant differences in Child-Pugh score, the degree of ascites, and the incidence of hepatic encephalopathy, hepatorenal syndrome, upper gastrointestinal bleeding, and the percentage of events of death or worsen (P<0.01, respectively).(3) Patients with mild to moderate disturbance showed a lower incidence in other liver cirrhosis complications, and the percentage of death or worsen, meanwhile a better degree of ascites and Child-Pugh score.Conclusion(1) Disturbance of electrolytes easily happens in the patients with liver cirrhosis ascites, especially hypohatremia and hypokalemia.(2) The bleeding of upper gastrointestinal tract and undue diuretic therapy are the most common remotes which cause electrolyte disturbance.(3) The clinical manifestations of electrolyte disturbance have few clinical features; mainly include anorexia, hypodynamia and abdominal distention.(4) Child-Pugh score and the degree of ascites are correlated to electrolyte disturbance, and have positive correlation to the degree of disturbance. (5) The incidence of hepatic encephalopathy, hepatorenal syndrome, upper gastrointestinal bleeding has high correlation to electrolyte disturbance.(6) Electrolyte disturbance is an important indicator of predicting the prognosis of patients with liver cirrhosis ascites, rational prevention and redress of electrolyte disturbance could reduce other cirrhosis complications and improve the treatment of ascites.