CAJ | 학술논문

目的：探讨多种利尿剂联合应用治疗难治性肝硬化腹水的临床疗效，并分析该疗法对电解质的影响。方法纳入2013年6月至2014年6月我院收治的100例难治性肝硬化腹水患者为研究对象，随机均分为观察组及对照组。前者首7d予安体舒通联合巯甲丙脯酸治疗，次7d视实际情况，酌情加用速尿联合多巴胺治疗，最后对未达预期疗效者予甘露醇治疗；后者应用白蛋白及速尿。均持续治疗28 d。对比两组疗效及治疗前后血及尿钠钾水平变化。结果观察组总有效率96．0％，明显高于对照组84．0％（ P＜0．05）；两组治疗前电解质水平接近，治疗后两组血钠、血钾无明显差异，且均接近于治疗前，上述差异均无统计学意义（P＞0．05），但两组24 h尿钠及24 h尿钾水平均明显上升，且观察组两项指标明显高于对照组，此差异有统计学意义（P＜0．05）。结论多种利尿剂联合应用，有助于提升难治性肝硬化腹水疗效，值得推广。
목적：탐토다충이뇨제연합응용치료난치성간경화복수적림상료효，병분석해요법대전해질적영향。방법납입2013년6월지2014년6월아원수치적100례난치성간경화복수환자위연구대상，수궤균분위관찰조급대조조。전자수7d여안체서통연합구갑병포산치료，차7d시실제정황，작정가용속뇨연합다파알치료，최후대미체예기료효자여감로순치료；후자응용백단백급속뇨。균지속치료28 d。대비량조료효급치료전후혈급뇨납갑수평변화。결과관찰조총유효솔96．0％，명현고우대조조84．0％（ P＜0．05）；량조치료전전해질수평접근，치료후량조혈납、혈갑무명현차이，차균접근우치료전，상술차이균무통계학의의（P＞0．05），단량조24 h뇨납급24 h뇨갑수평균명현상승，차관찰조량항지표명현고우대조조，차차이유통계학의의（P＜0．05）。결론다충이뇨제연합응용，유조우제승난치성간경화복수료효，치득추엄。
Objective This paper was to investigate the clinical effect of combining multiple diuretics in the treatment of refractory cirrhotic ascites and to analyze the effect on electrolyte.Methods 100 patients with refractory cirrhotic ascites in our hospital during June 2013 and June 2014 were selected as the research object. They were randomly divided into observation group and control group.The former were treated with spironolactone and captopril at the first 7 days.Then depending on the actual situation, some of them got furosemide combined with dopamine as a combination.Finally, patients whose curative effects were not reached expect got mannitol therapy as a combination.While the control group got only albumin and furosemide.The treatment lasted for 28 days.Then we compared their treatment effect and the change of Na +and K +levels in blood and urine. Results The total efficiency rate of the observation group was 96.0%, which was significantly higher than 84. 0%of the control group (P<0.05).Before treatment, serum Na+and K+, 24h urine Na+and K+of the two groups were similar, without significant difference.The serum Na+and K+of two groups after treatment were also similar, and were similar to the date before treatment.Differences above all showed no statistically significance (P>0.05).But the 24h urine Na+and K+of both groups were significantly increased, and the two indexes of the observation group were obviously higher than that of control group, the difference has statistically significant (P<0.05).Conclusions The combination of multiple diuretics helps to increase the curative effect of refractory ascites due to cirrhosis, it is worth promoting.