[Paracentesis associated to dextran-70 in the treatment of ascites in patients with chronic liver diseases: a randomized therapeutic study].
The treatment of ascites of large volume in chronic liver disease patients was evaluated in the present study. We compared diuretics with paracentesis and an infusion of Dextran-70. Therapeutic efficacy, complications and length of hospital stay were the variables studied. Of the 38 patients, 20 were selected randomly. They were evaluated using clinical, laboratory and/or histological criteria: 10 patients in the paracentesis group with Dextran-70 and 10 in the diuretic group. The groups were similar with respect to age, diagnosis and Child-Pugh classification. However, there was a greater number of males in the paracentesis group with Dextran-70. In each paracentesis, an average of 9.41 liters (4.5 to 14.1) of ascitic fluid was collected. The average hospitalization period in the paracentesis group with Dextran-70 was 10.5 days (8-14), significantly less when compared to the diuretic group: 24.4 days (14-48). In the diuretic group one patient presented complications such as hyperkalemia, increased urea and creatinine levels, while in the paracentesis group with Dextran-70 one patient presented a temperature above 38 degrees C during treatment. The results suggest that paracentesis associated with Dextran-70 could be a therapeutic alternative for chronic liver disease patients with ascites in our population. It was effective; it had no significant side effects; it reduced the length of hospital stay and therefore should decrease the cost and the risk of complications in patients requiring prolonged hospitalization periods.
Cotrim
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HP
Serviço de Gastro-Hepatologia, Hospital Universitário Prof. Edgar Santos - Universidade Federal da Bahia.
Garrido
V
V
Paraná
R
R
Santana
G
G
Dultra
D
D
Pinto
M
M
Lyra
L
L
D001201:Ascites / Q000188:drug therapy / Q000191:economics / Q000209:etiology / Q000628:therapy*; D002908:Chronic Disease; D003911:Dextrans / Q000627:therapeutic use*; D004232:Diuretics / Q000627:therapeutic use*; D005260:Female; D006509:Hepatitis B / Q000150:complications; D006801:Humans; D007902:Length of Stay; D008108:Liver Diseases, Alcoholic / Q000150:complications; D008297:Male; D008875:Middle Aged; D011677:Punctures
D003911:Dextrans; D004232:Diuretics
Paracentese associada a Dextran-70 no tratamento da ascite de hepatopatas crônicos: ensaio terapêutico randomizado.