Ascites is one of the most common complications of liver cirrhosis associated with a poor prognosis. The first line treatment of ascites requires dietary sodium restriction and the judicious use of di-uretics, such as spironolactone and furosemide. Patients with refractory ascites require second-line treat-ments of repeat large-volume paracentesis (LVP) or the insertion of a transjugular intrahepatic portosystemic shunt (TIPS), and assessment for liver transplantation. The use of albumin as a volume expander is recom-mended for LVP of >5 L to prevent the development of circulatory dysfunction, although the clinical signif-icance of post-paracentesis circulatory dysfunction is still debated. Potential new treatment options for as-cites include the use of vasopressin V2 receptor antagonists and vasoconstrictors, which could possibly im-prove the management of ascites. Clinical pharmacists can optimize treatment plans with doctors and imple-ment pharmaceutical care for patients to promote rational use of drugs.%腹水是肝硬化最常见的并发症之一，其出现往往提示预后不良。腹水的一线治疗包括限钠饮食和规范使用利尿剂，如口服螺内酯和呋塞米。难治性腹水患者需要系列的大量穿刺放腹水（LVP）或经颈静脉肝内门-体分流术（TIPS）治疗，并评估是否适合肝移植。尽管大量穿刺放腹水、使用白蛋白预防循环功能障碍仍有争议，但临床以大量穿刺放腹水（>5 L）并输注白蛋白预防循环功能障碍多见。治疗腹水新方法包括使用血管加压素V2受体拮抗剂和血管收缩剂，有可能改善腹水的治疗。临床药师可协同临床医师优化治疗方案，实施药学监护，以促进临床合理用药。
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