末期肝硬化併頑固型腹水病人接受居家安寧雙導管腹腔穿刺及腹水引流：一病例報告

Double-Catheter Abdominal Paracentesis for Liver Cirrhosis Patient with Refractory Ascites: A Case Report

末期肝硬化病人合併有頑固型腹水屬於居家安寧收案條件之一，提供腹腔穿刺 及腹水引流是居家安寧療護的服務項目之一。此類病人常因腹水導致腹脹、食慾降 低、身體乏力等不適症狀，須要腹水引流。當病人有此需求且到醫院接受腹水引流 有不便利時，經醫師評估後，可在居家安寧服務時從事腹水引流。本文分享一個案 例，病人因腦中風合併意識不清及肝硬化併頑固型腹水接受居家安寧療護。因病人 意識不清，在作腹水引流的過程中無法長時間的配合。醫師與家屬討論後同意使用 雙腹腔穿刺及腹水引流來減少腹水引流的時間。

 

Patients with cirrhosis having refractory ascites often suffer abdominal distention due to ascites, loss of appetite, physical fatigue and other symptoms requiring subsequent frequent abdominal paracentesis. Providing abdominal paracentesis is one of the services of home hospice care. When patients with such demands have difficulty receiving abdominal paracentesis in the hospital, the drainage of ascites can be performed during home hospice service upon evaluation by the physician. This article shares a case who received home hospice care due to cirrhosis with refractory ascites and unclear consciousness induced by stroke. Because of the unclear consciousness of the patient, he was not able to cooperate during the abdominal paracentesis procedure. After our discussion with his family members, physician used double-catheter abdominal paracentesis in order to reduce the time needed for ascites drainage of. As for the outcome, the entire course of the procedure went smoothly with no obvious complications.