托拉塞米与呋塞米对肝硬化腹水患者利尿引起的低钾血症风险对比研究

A Comparative Study of Torasemide and Furosemide on the Risk of Hypokalemia Caused by Diuresis in Patients with Cirrhotic Ascites

目的比较托拉塞米与呋塞米对肝硬化腹水患者利尿引起的低钾血症风险。方法选取2021年10月-2023年9月瑞金市人民医院收治的66例肝硬化腹水患者为研究对象,按照随机数字表法分为呋塞米治疗组和托拉塞米治疗组,各33例。呋塞米治疗组用呋塞米治疗,托拉塞米治疗组用托拉塞米治疗。比较两组利尿效果(体重、尿量)、血清电解质情况(血钾、血钠)及不良反应(肝肿大、感染、腹膜炎、消化道出血、肝性脑病)发生率。结果托拉塞米治疗组利尿效果优于呋塞米治疗组(P<0.05);治疗3 d后,托拉塞米治疗组血钾、血钠水平均高于呋塞米治疗组(P<0.05);托拉塞米治疗组不良反应发生率低于呋塞米治疗组(P<0.05)。结论托拉塞米对肝硬化腹水患者血钾、血钠等改善作用明显,能促进尿液排出,治疗效果和安全性更高,值得应用。

Objective To compare the risk of diuretic-induced hypokalemia between torasemide and furosemide in patients with cirrhotic ascites.Methods A total of 66 patients with cirrhotic ascites admitted to Ruijin People's Hospital from October 2021 to September 2023 were selected as the research objects.According to the random number table method,they were divided into furosemide treatment group and torasemide treatment group,with 33 patients in each group.The furosemide treatment group was treated with furosemide,and the torasemide treatment group was treated with torasemide.The diuretic effect(body weight,urine volume),serum electrolyte(serum potassium,serum sodium)and the incidence of adverse reactions(hepatomegaly,infection,peritonitis,gastrointestinal bleeding,hepatic encephalopathy)were compared between the two groups.Results The diuretic effect of torasemide treatment group was better than that of furosemide treatment group(P<0.05).After 3 days of treatment,the levels of serum potassium and sodium in the torasemide treatment group were higher than those in the furosemide treatment group(P<0.05).The incidence of adverse reactions in the torasemide treatment group was lower than that in the furosemide treatment group(P<0.05).Conclusion Torasemide can significantly improve serum potassium and serum sodium in patients with cirrhotic ascites,promote urine excretion,and has higher therapeutic effect and safety.It is worthy of application.