Ascites is an important indicator of poor prognosis of liver cirrhosis.Although several guidelines and consensus statements on the management of ascites have been published in the past years,there are still a lot of controversial problems in this regard.The current contro-versial problems and difficulties in the management of ascites,such as the timing of sodium supplementation or sodium restriction,the selec-tion of diuretics,the application value of aquaretics,the strategy of albumin administration after large-volume paracentesis,and the indica-tions and efficacy of transjugular intrahepatic portosystemic shunt,are reviewed.It is pointed out that further studies on these problems with evidence-based medicine means will enhance the diagnosis and treatment of cirrhotic ascites and improve patients'prognosis.%腹水是肝硬化预后不良的重要指标。近年来尽管出台了很多有关肝硬化腹水的指南和共识，但其处理中仍存在一些争议。回顾了目前肝硬化腹水处置中的难点及争议问题，如补钠和限钠的时机、利尿剂的选择、利水剂的应用价值、大量放腹水后补充白蛋白的方案、经颈静脉肝内门体分流术的指征和疗效等；并指出运用循证医学手段解决上述争议性问题，有助于提高肝硬化腹水的诊疗水平，改善患者预后。
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