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不同利尿方案对肝癌患者肝切除术后相关指标的影响
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| 篇名： | 不同利尿方案对肝癌患者肝切除术后相关指标的影响 |
| TITLE： | |
| 摘要： | 目的：探讨不同利尿方案对肝癌患者肝切除术后相关指标的影响。方法：60例拟行肝癌肝切除手术的患者随机分为研究组（30例）和对照组（30例）。术后在常规治疗的基础上，研究组患者给予螺内酯片100 mg，qd+呋塞米片40 mg，qd，于每日早饭后服用；对照组患者给予螺内酯片100 mg，bid，于每日早饭后和下午16时口服+呋塞米片20 mg，qd，于每日早饭后口服。两组患者均每3日复查电解质及肝肾功能，并根据体质量和液体出入量变化调整利尿方案。观察两组患者利尿治疗有效性指标（体质量减轻、利尿治疗有效例数、静脉使用利尿药频次、羟乙基淀粉使用频次、夜间排尿频次、术后住院时间、腹水消退时间），治疗前后血钠、血钾、血肌酐、血尿素氮、血白蛋白、丙氨酸转氨酶、天冬氨酸转氨酶、谷酰转肽酶及不良反应发生情况。结果：研究组患者夜间排尿频次显著少于对照组，差异均有统计学意义（P＜0.05）；两组患者体质量减轻、利尿治疗有效例数、静脉使用利尿药频次、羟乙基淀粉使用频次、术后住院时间、腹水消退时间等比较，差异均无统计学意义（P＞0.05）。治疗后，两组患者血钠、血白蛋白水平均显著低于同组治疗前；两组患者血钾、血尿素氮、丙氨酸转氨酶、天冬氨酸转氨酶、谷酰转肽酶水平均显著高于同组治疗前，差异均有统计学意义（P＜0.05）；但两组间血钠、血钾、血尿素氮、血白蛋白、丙氨酸转氨酶、天冬氨酸转氨酶、谷酰转肽酶及治疗前后血肌酐比较，差异均无统计学意义（P＞0.05）。两组患者利尿相关不良反应发生率比较，差异无统计学意义（P＞0.05）。结论：在常规治疗的基础上，两种利尿方案均可有效避免肝癌患者肝切除术后腹水形成，减少相关并发症的发生，但螺内酯100 mg，qd+呋塞米40 mg，qd，每日早饭后服药的给药方法能显著降低患者夜间排尿次数，提高用药依从性。 |
| ABSTRACT： | OBJECTIVE： To investigate the effects of different diuretic regimens on related indicatora in hepatocellular carcinoma patients after hepatic resection. METHODS： A total of 60 hepatocellular carcinoma patients undergoing hepatic resection were randomly divided into study group （30 cases） and control group （30 cases）. After surgery， study group was given Spironolactone tablet 100 mg+Furosemide tablet 40 mg， qd， after breakfast； Control group was given Spironolactone tablet 100 mg orally， bid， after breakfast and at 16：00+Furosemide tablet 20 mg， qd， after breakfast. Electrolyte， liver and renal function of 2 groups were rechecked every 3 days； diuretic regimen was adjusted according to body weight and volume of liquid intake and output. The effectiveness indexes of diuretic treatment were observed in 2 groups，such as the decrease of body weight， case number of effective diuretic treatment，frequency of intravenous dieresis，frequency of hydroxyethl starch use，frequency of night arination，postoperative hospitalization stay，the time of ascites extinction； serum sodium，serum potassium， serum creatinine， blood urea nitrogen， serum albumin， ALT，AST，GGT， the occurrence of ADR were observed before and after treatment. RESULTS： The nocturnal micturition frequency of study group was significantly lower than that of control group， with statistical significance （P＜0.05）. There was no significant difference in the decrease of body weight， response rate of diuretic treatment， frequency of intravenous dieresis， frequency of hydroxyethyl starch use， postoperative hospitalization stay or the time of ascites extinction between 2 groups （P＞0.05）. After treatment， the levels of serum sodium and serum albumin in 2 groups were decreased significantly， compared to before treatment； the levels of blood urea nitrogen， serum potassium and ALT， AST，GGT in 2 groups were significantly higher than before treatment， with statistical significance （P＜0.05）. There was no statistical significance in the levels of serum sodium， serum potassium， blood urea nitrogen， serum albumin or ALT， AST， GGT between 2 groups （P＞0.05）. There was no statistical significance in the incidence of ADR between 2 groups （P＞0.05）. CONCLUSIONS： Both two diuretic regimens can effectively avoid the occurrence of postoperative ascites formation and related complication in patients hepatocellular carcinoma after hepatic resection. The drug regimens of spironolactore 100 mg，qd+furosemide 40 mg，qd after breakfast can significantly reduce nocturnal micturition frequency and improve medication compliance. |
| 期刊： | 2017年第28卷第33期 |
| 作者： | 刘金永，卞晓洁，仇毓东，葛卫红，周长江 |
| AUTHORS： | LIU Jinyong，BIAN Xiaojie，QIU Yudong，GE Weihong，ZHOU Changjiang |
| 关键字： | 肝癌；肝切除术；利尿；螺内酯；呋塞米；腹水；并发症 |
| KEYWORDS： | Hepatocellular carcinoma； Hepatic resection； Diuretic； Spironolactone； Furosemide； Ascites； Compliance |
| 阅读数： | 386 次 |
| 本月下载数： | 2 次 |
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