甘露醇联合多巴胺治疗肝硬化难治性腹水的疗效观察

The efficacy of mannital combined with dopamine for the treatment of refractory ascites in cirrhosis

目的探讨甘露醇联合多巴胺治疗肝硬化难治性腹水的疗效及安全性。方法92例肝硬化难治性腹水患者被随机分为两组,对照组(42例)给予多巴胺40mg,以(0.5～2)μg.kg-1.min-1的速度静滴和呋噻米40mg静脉注射,治疗组(50例)给予20%甘露醇250ml、呋噻米40mg静滴和多巴胺40mg,以(0.5～2)μg.kg-1.min-1的速度静滴,两组均常规综合治疗。观察患者治疗后的主要症状和体征、每日尿量、腹水的消退情况、并发症及药物不良反应。结果治疗组总有效率(86.0%)高于对照组(61.9%)(P<0.01),第1、2周日平均尿量也显著高于对照组(P<0.01),治疗后两组血生化及肾功能指标间差异无统计学意义(P>0.05),治疗组无明显的药物不良反应。结论甘露醇联合多巴胺治疗肝硬化难治性腹水有较好的疗效和安全性。

Objective To explore the therapeutic efficacy and safety of mannital combined with dopamine for the treatment of refractory ascites in cirrhosis.Methods 92 patients with refractory ascites in cirrhosis were randomly divided in to two groups.The control group （n=42） was given dopamine 40mg by 0.5-2？g/（kg/min） intravenous drip and furosemide 40mg by intravenous injection.The treatment group （n=50） was given 20% mannital 250ml,furosemide 40mg by intravenous drip and dopamine 40mg by 0.5-2？g/（kg/min） speed intravenous drip.The conventional treatment was also administered for both groups.Clinical data including main symptoms and signs,daily amount of urine,ascites retrogression situation,complications and adverse drug reactions were monitored.Results The treatment efficacy was higher （86%） in the treatment group than the control group （61.9%） （p〈0.01）.The 1st and 2nd weeks of daily average urine output was higher in the treatment group than the control group （p〈0.01）.There was no significant difference in blood chemistry and kidney function tests between the two groups （p〉0.05）.No remarkable adverse effect was observed.Conclusion Mannital combined with dopamine is clinically effective and safe in treating refractory ascites in cirrhosis patients.