羟乙基淀粉联合呋塞米治疗肾病综合征水肿的研究

Research on combination therapy of hydroxyethyl starch with furosemide for nephrotic syndrome edema

目的：探讨羟乙基淀粉联合呋塞米在治疗肾病综合征水肿患者的临床作用.方法：选取进行治疗的肾病综合征水肿患者60例,随机分为两组：观察组30例,以6％的羟乙基淀粉（HES130/0.4）加20 ～ 120 mg呋塞米静脉滴注;对照组30例,静脉输入人体白蛋白后静脉注射呋塞米.观察两组患者出现多尿时间、水肿消退时间、凝血功能、肝肾功能、24 h尿蛋白的变化及不良反应.结果：自患者输入羟乙基淀粉治疗当天开始,患者尿量增加明显（P＜0.05）;体重下降明显,水肿明显消退;凝血功能PT无明显变化,尿蛋白转阴天数为28天.两组患者的凝血功能变化、尿蛋白转阴天数对比,差异具有统计学意义（P＜0.05）.结论：羟乙基淀粉联合呋塞米治疗肾病综合征伴水肿效果明显,无不良反应.

Objective To explore the clinical effect of the combination therapy of hydroxyethyl starch with furosemide for patients suf- fering from nephrotic syndrome edema. Methods Sixty patients with nephrotic syndrome edema receiving therapy from June 2011 to De- cember 2011 in this hospital were selected and randomly divided into two groups： 30 cases in the observation group, with 6% hydroxyethyl starch （HES130/0. 4） and 20 - 120rag of frosemide for intravenous drip; 30 cases in the control group, with intravenous infection of frosemide after intravenous input of human albumin. Observe the two groups of patients for polyuria time, edema fading time,blood clotting function, hepatorenal function,urinary protein changes in 24h and adverse reactions. Results Since the day when the patient was input with hydroxyethyl for treatment,the patient urine output has significantly increased （ P 〈 0. 05 ） ; Weight loss is obvious and edema has faded ob- viously; Blood clotting function PT has no obvious change and the days of urine protein being negative are 28 days. The changes of blood clotting function and the days of urine protein being negative in the two groups of patients have been compared, and the difference is statisti- cally significant （ P 〈 0. 05 ）. Conclusion The effect of combination therapy of hydrbxyethyl starch with furosemid~, for nephrotic syndrome edema is obvious,without adverse reactions.