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| 1 | Natural history and outcomes of patients with liver cirrhosis complicated by hepatic hydrothorax显示文摘BACKGROUNDHepatic hydrothorax (HH) is an uncommon and difficult-to-manage complicationof cirrhosis with limited treatment options.AIMTo define the clinical outcomes of patients presenting with HH managed withcurrent standards-of-care and to identify factors associated with mortality.METHODSCirrhotic patients with HH presenting to 3 tertiary centres from 2010 to 2018 wereretrospectively identified. HH was defined as pleural effusion in the absence ofcardiopulmonary disease. The primary outcomes were overall and transplant-freesurvival at 12-mo after the index admission. Cox proportional hazards analysiswas used to determine factors associated with the primary outcomes.RESULTSOverall, 84 patients were included (mean age, 58 years) with a mean model forend-stage liver disease score of 29. Management with diuretics alone achievedlong-term resolution of HH in only 12% patients. At least one thoracocentesis wasperformed in 73.8% patients, transjugular intrahepatic portosystemic shuntinsertion in 11.9% patients and 33% patients received liver transplantation within12-mo of index admission. Overall patient survival and transplant-free survival at12 mo were 68% and 41% respectively. At multivariable analysis, current smoking [hazard ratio (HR) = 8.65, 95% confidence interval (CI): 3.43-21.9, P < 0.001) and acute kidneyinjury (AKI) (HR = 2.91, 95%CI: 1.21-6.97, P = 0.017) were associated with a significantly increasedrisk of mortality.CONCLUSIONCirrhotic patients with HH are a challenging population with a poor 12-mo survival despitecurrent treatments. Current smoking and episodes of AKI are potential modifiable factors affectingsurvival. HH is often refractory of diuretic therapy and transplant assessment should beconsidered in all cases. | Sarah Romero Andy KH Lim Gurpreet Singh Chamani Kodikara Rachel Shingaki-Wells Lynna Chen Samuel Hui Marcus Robertson | 2022 | World Journal of Gastroenterology2022，28，35： | 0 |
| 2 | 肝性胸水的诊疗进展显示文摘肝性胸水是晚期肝病和门脉高压较少见的并发症,因其在少量情况下就可以引起症状,且预后差,一旦出现需要进行积极的干预和治疗,缓解病情的发展,预防出现自发性胸膜炎等并发症,为患者等待肝移植赢得宝贵的时间。此文就近几年肝性胸水诊断和治疗方法的新进展进行综述,以期为临床肝性胸水的早期诊疗提供参考。 | 姜芬 石建凤 王莉 | 2014 | 国际流行病学传染病学杂志2014，41，5： | 0 |
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