Clinical Analysis Of The Cirrhosis Ascites With Hyponatremia

Background: Liver Cirrhosis is the disease with performance of liverdamage and portal hypertension usually based on chronic liver disease.Decompensated cirrhosis ascites patients usually accompany different degreehyponatremia.Clinical observation found the close relations betweenhyponatremia and liver cirrhosis complications and prognosis. Therefore, moreattention is payed to the hyponatremia in the treatment of cirrhosis ascites.Aim: To observe and discuss the clinical associations，curative effect andprognostic impact of hyponatremia in the cirrhotic ascites inpatients, and inorder to provide the reference of the treatment of cirrhosis ascites.Methods: According to the standard of the2000years’《prevention andtreatment plan of viral hepatitis》, collectting260cases of patients with livercirrhosis ascites from2010-2011. Serum sodium, functions of hepatic and renalwere obtained within48hours after hospitalization. All of the patients weredivided into normal serum sodium group (Na+≥135mmol/l, group A) andhyponatremia group (Na+＜135mmol/l, group B), group B was further dividedinto the mild-moderate group (120mmol/l≤Na+＜135mmol/l,group b1) andsevere group (Na+＜120mmol/l, group b2). Abdominal ultrasound wascompleted within3days in all of the patients, part of the patients completedliver CT or MRI, gastroscope examination. All of the patients accetped protectliver, albumin supplementation, adjust the water and electrolyte balance, diuresisand related treatment, seru melectrolytes levels were monitored every other day,functions of hepatic and renal were obtained every week；To evaluate the therapeutic effect of ascites two weeks later by ultrasonography B, analyse thecomplication and prognosis as soon as the patients were out of the hospital.Results：(1)102cases of hyponatremia were found in260inpatients(39.28%),inwhich64cases with mild-moderate hyponatremia and38cases with severehyponatremia.(2) There were significant difference in incidence of hepatic encephalopathy,hepatorenal syndrome, upper gastrointestinal bleeding and spontaneous bacterialperitonitis, degree of ascites, therapeutic effect of ascites, Child-Pugh score andpercentage of events of death or worsen, comparing the patients withhyponatremia with those with normal serum sodium (P＜0.01, respectively).(3) Comparing the patients with mild-moderate hyponatremia with thosewith severe hyponatremia, there were lower incidence in hepatic encephalopathy,hepatorenal syndrome, upper gastrointestinal bleeding, spontaneous bacterialperitonitis and events of death or worsen (P＜0.01, respectively), while bettertherapeutic effect of ascites, degree of ascites and Child-Pugh score (P＜0.01,respectively).Conclusion：(1) Disturbance of electrolytes is easily happened in the patients with livercirrhosis ascites, especially hypohatremia.(2) The incidence of hepatic encephalopathy, hepatorenal syndrome, uppergastrointestinal bleeding and spontaneous bacterial peritonitis has highcorrelation to hyponatremia, and it has positive correlation to the degree ofhyponatremia.(3) The degree of ascites, therapeutic effect of ascites and Child-Pugh scorehave high correlation to hyponatremia, and it has positive correlation to thedegree of hyponatremia. (4) Hyponatremia is the important indicator of predicting the prognosis ofpatients with liver cirrhosis ascites, Supplement sodium properly is benefit forthe treatment of ascites and reducing complications.