低分子右旋糖酐联用速尿持续静滴治疗小儿肾病综合征水肿的效果

Clinical research of low molecule dextran combined with furosemide continuous infusion for the treatment of children with nephrotic syndrome

目的探讨低分子右旋糖酐联合速尿持续静滴治疗／bJL肾病综合征水肿的临床效果。方法收集2013年1月～2014年1月衢州市人民医院收治的肾病综合征水肿患儿52例，随机将其分为观察组与对照组，每组各26例，两组均予以常规治疗，对照组应用速尿持续静滴，观察组则予以低分子右旋糖酐联合速尿持续静滴，比较两组的临床疗效。结果观察组的治疗总有效率为100．O％，显著高于对照组（80．8％），差异有统计学意义（P＜0．05）；水肿开始消退时间、血清白蛋白升高时间、多尿时间依次为（15．9±4．2）h、（7．8±1．1）d、（3．5±1.3）h，均较对照组[（28．4±1213）h、（12．3±1．4）d、（14．3±2．9）h]显著缩短，差异均有统计学意义（P〈0．05）；治疗后两组的24h尿蛋白及血清胆固醇均较治疗前显著降低，但观察组显著低于对照组，差异均有统计学意义（P＜0．05）；两组治疗后血清白蛋白水平均明显升高，但观察组显著高于对照组，差异有统计学意义（P＜0．05）；观察组停药后水肿复发率为7．7％，显著低于对照组（42．3％），差异有统计学意义（P＜0．05）。结论低分子右旋糖酐联合用速尿持续静滴治疗小儿肾病综合征水肿效果显著，不良反应少，值得临床推广应用。

Objective To investigate the clinical efficacy of low molecule dextran combined with furosemide continuous infusion for the treatment of children with nephrotic syndrome. Methods 52 cases of children with nephrotic syndrome from January 2013 and January 2014 in the People＇s Hospital of Quzhou City in Zhejiang Province were collected. The children were divided into observation group and control group randomly, with 26 cases in each group. The two groups were received routine treatment, and the control group were given uroscmide continuous infusion, the observation group were given low molecule dextran combined with furosemide continuous infusion. The clinical efficacy of the two groups were compared. Results The total effective rate of observation group was 100.0%, significantly higher than that in the control group （80.8%）, the difference was statistically significant （P 〈0.05）; the time of swelling began to subside, elevated serum albumin, and polyuria of observation group were （15.9±4.2） h, （7.8±1.1） d, （3.5±1.3） h respectively, which were significantly shorter than those of the control group [（28.4＋12.3） h, （12.3±1.4） d, （14.3±2.9） h], the differences were statistically significant （P 〈0.05）. After treatment, the 24 h urine protein and serum cholesterol in the two groups were significantly reduced compared with before treatment, and the observation group were lower than those of the control group, the differences were statistically significant （P 〈0.05）; the serum albumin levels of the two groups were sig- nificantly elevated, but the observation group was significantly higher than the control group, the difference was statistically significant （P 〈0.05）. After discontinuation, the edema relapse of the observation group was 7.7%, significantly lower than that in the control group （42.3%）, the difference was statistically significant （P 〈0.05）. Conclusion The low molecule dextran combined with furosemide continuous infusion for the treatment of children with nephrotie syndrome has a significant effect and fewer adverse reactions, it is worthy of clinical application.