摘要
目的观察甘露醇联合奥曲肽治疗失代偿期肝硬化合并顽固性腹腔积液患者的临床疗效及对尿量的影响。方法回顾性选取福建省级机关医院2019年1月—2022年1月收治的失代偿期肝硬化合并顽固性腹腔积液患者60例,按治疗方法分为对照组与观察组,各30例。2组患者均进行常规治疗,观察组在常规治疗基础上加用甘露醇及奥曲肽治疗。患者治疗时间均为7~21 d,而后随访8周。比较2组临床疗效,治疗前及治疗结束后的腹围、体质量、24 h尿量、腹腔积液深度、血钠、肝纤维化指标[透明质酸(HA)、层黏连蛋白(LN)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原蛋白(Ⅳ-C)]及不良反应。结果观察组总有效率高于对照组(96.67%vs.76.67%,χ^(2)=5.192,P=0.023)。治疗结束后,2组腹围、腹腔积液深度小于治疗前,体质量低于治疗前,24 h尿量多于治疗前,血钠水平高于治疗前,且观察组各指标优于对照组(P<0.05或P<0.01);2组血清HA、LN、PCⅢ及Ⅳ-C水平均低于治疗前,且观察组低于对照组(P<0.01)。观察组口干口渴、头痛、腹痛及恶心呕吐的总发生率低于对照组(3.33%vs.23.33%,χ^(2)=5.192,P=0.023)。结论甘露醇联合奥曲肽治疗失代偿期肝硬化合并顽固性腹腔积液患者可增强疗效,改善水钠潴留,增多尿量,促进腹腔积液消退,且安全性较高。
Objective To observe the clinical efficacy of mannitol combined with octreotide in the treatment of decompensated cirrhosis patients complicated with intractable peritoneal effusion and the impact on urine output.Methods A total of 60 cases of decompensated cirrhosis patients complicated with intractable peritoneal effusion were retrospectively selected from January 2019 to January 2022 in Fujian Provincial Governmental Hospital,and they were divided into the control group and the observation group according to treatment methods,30 cases in each group.Both groups were treated conventionally,and the observation group was treated with mannitol combined with octreotide on the basis of conventional treatment.The patients were treated for 7-21 days,then followed up for 8 weeks.Clinical efficacy,abdominal circumference,body mass,24 h urine volume,peritoneal fluid depth,blood sodium,liver fibrosis indexes(HA,LN,PCⅢ,Ⅳ-C)before and after the end of treatment,and adverse reactions in the two groups were compared.Results The total effective rate in the observation group was higher than that in the control group(96.67%vs.76.67%,χ^(2)=5.192,P=0.023).At the end of treatment,abdominal circumference and peritoneal fluid depth in the two groups were smaller than those before treatment,body mass was lower than that before treatment,24 h urine volume was more than that before treatment,and blood sodium level was higher than that before treatment,and the indexes in the observation group were better than those in the control group(P<0.05 or P<0.01);Serum HA,LN,PCⅢandⅣ-C levels in the two groups were lower than those before treatment,and the observation group were lower than those in the control group(P<0.01).The overall incidence of dry mouth and thirst,headache,abdominal pain and nausea and vomiting in the observation group was lower than that in the control group(3.33%vs.23.33%,χ^(2)=5.192,P=0.023).Conclusion Mannitol combined with octreotide can enhance the efficacy in the treatment of decompensated cirrhosis patients complicated with intractable peritoneal effusion,it can improve water-sodium retention,increase urine output,and promote peritoneal effusion regression,and with higher safety.
作者
林锦燕
缪晓峰
LIN Jinyan;MIAO Xiaofeng(Department of Gastroenterology,Fujian Provincial Governmental Hospital,Fuzhou 350003,China)
出处
《临床合理用药杂志》
2023年第21期21-24,共4页
Chinese Journal of Clinical Rational Drug Use
关键词
肝硬化
失代偿期
顽固性腹腔积液
甘露醇
奥曲肽
尿量
治疗结果
Cirrhosis,decompensated stage
Intractable peritoneal effusion
Mannitol
Octreotide
Urine output
Treatment outcome
