奥曲肽治疗肝性胸水临床观察分析

Clinical Observation and Analysis of Octreotide in the Treatment of Hepatic Hydrothorax

目的:探讨肝性胸水的发病机制及奥曲肽治疗的临床疗效。方法:收集45例肝性胸水患者,随机分为治疗组23例和对照组22例,对照组采用常规限制水、钠盐摄入,补充血浆或白蛋白,利尿及营养支持治疗,治疗组在常规治疗基础上给予奥曲肽0.1 mg皮下注射,8 h/次治疗,疗程2周,治疗后观察临床症状、胸水及尿量变化情况。结果:根据胸片观察胸水的变化,评估疗效,治疗组总有效率86.9%,明显高于对照组68.1%,两组比较差异有统计学意义(P<0.05)。治疗组24 h尿量(2045±352)mL较对照组24 h尿量(1468±187)mL明显增加,两组比较差异有统计学意义(P<0.05)。结论:奥曲肽通过降低门静脉压力,增加肾血流灌注,能有效治疗肝性胸水。

Objective:To investigate the pathogenesis of hepatic hydrothorax and the clinical efficacy of octreotide treatment for hepatic hydrothorax.Method:45 patients with hepatic hydrothorax were collected and randomly divided into treatment group of 23 cases and control group of 22 cases.The control group was treated with routine restriction of water and sodium,plasma or albumin infusion,applying diuretics and nutritional support.On the basis of routine treatment,the treatment group received Octreotide 0.1 mg subcutaneous injection,3 times daily for 2 weeks.After treatment,the clinical symptoms,hydrothorax and urine output of two groups were observed.Result:According to X-ray,evaluate the change of hydrothorax,the total effective rate was 86.9%in the treatment group,which was significantly higher than that control group of 68.1%,the difference was statistically significant(P<0.05).The 24 h urine output in the treatment group was(2445±352)mL significantly increased than that of control group(1468±187)mL,the difference was statistically significant(P<0.05).Conclusion:Octreotide can effectively treat hepatic hydrothorax by reducing portal venous pressure and increasing renal blood flow.