Ascites examination

The serosal cavity of the human body, such as the pleural cavity, peritoneal cavity, and pericardial cavity, has only a small amount of liquid under normal conditions, and it has a lubricating effect in the cavity and can rarely be extracted. However, under pathological conditions, a large amount of liquid is stored to form a effusion. According to the cause of the effusion and its traits, the serous effusion can be divided into two categories: leakage and exudate. Basic Information Specialist classification: Digestive examination classification: chest and ascites examination Applicable gender: whether men and women apply fasting: not fasting Tips: Tell the doctor about the history of medication and medical history. Especially if there is a history of hypertension. Normal value 20 ~ 50ml. Clinical significance Abnormal result (1) exudate 1 peritonitis A. abdominal visceral rupture. B. Tuberculous peritonitis. C. Primary peritonitis (idiopathic bacterial peritonitis). D. Pancreatitis. E. Bile peritonitis. 2 malignant tumor A. liver or peritoneal metastasis. B. Leukemia, malignant lymphoma, etc. C. Primary hepatocytes or cholangioblastoma. (2) chyle-like ascites caused by lymphatic stenosis 1 trauma with chest tube obstruction. 2 mediastinal tumor. 3 tuberculosis. 4 cirrhosis. 5 filariasis. 6 nephrotic syndrome. (3) Leakage 1 dystrophic edema (hypoproteinemia) with systemic edema A. nephrotic syndrome. B. Protein leakage gastrointestinal disorder. C. Low nutrition. 2 right heart dysfunction A. Congestive heart failure. B. Tricuspid occlusion is incomplete. C. Constrictive pericarditis. 3 hepatic vein or inferior vena cava obstruction A. Bard-Gihale syndrome (hepatic vein occlusion syndrome), tumor. B. Hepatic vein occlusion disease. 4 diffuse liver disease with cirrhosis of portal hypertension. 5 lesions infiltrated into the liver A. Tumors, lymphomas, myeloid metaplasia, etc. B. Granulomatous disease (sarcoma-like disease, schistosomiasis). 6 portal vein infarction. (4) Others 1 hypothyroidism (mucus edema). 2 ovarian disease A. McGregor syndrome (Meggs syndrome, ovarian-ascites-thoracic syndrome). B. Ovarian thyroid tumor. C. Ovarian hyperstimulation syndrome. 3 bladder injury urinary peritoneal effusion. Precautions Preparation before inspection: Inform the doctor about the history of the medicine and the medical history. Especially if there is a history of hypertension. Requirements for inspection: 1. Quietly treated by a doctor. 2. The doctor should perform the puncture and extraction at the effusion site under aseptic conditions, and the specimen should be sent immediately. Not suitable for people: Hypertensive patients should consult a doctor. Inspection process The principle of ascites examination: The normal slurry contains a small amount of acidic glycoprotein, the filtrate content is very small, the exudate content is more, and its isoelectric point is pH 3-5. When the content is high, it is white precipitated in the dilute acetic acid solution, so the exudate is mostly positive, and the filtrate is often negative. Reagents: With Li Fan, he tested the law. Operation method: Take 100ml of water in the measuring cylinder, add 2~3 drops of glacial acetic acid, mix and add 1 drop of the sample to be tested. If the solution in the tube is white turbid or flocculent precipitate is positive, if the turbidity disappears in the middle, it will be negative. Not suitable for the crowd Not suitable for the crowd: need to check the crowd for swelling of the abdomen, press the movable person. Those without examination indications should not be tested. Hypertensive patients should consult a doctor. Adverse reactions and risks Infection: Pay attention to aseptic operation during puncture, pay attention to local cleaning after puncture, prevent water pollution and avoid infection.