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目的:观察托拉塞米与呋塞米治疗儿童肾病综合征引起水肿的临床疗效。方法:选取54例儿童肾病综合征患儿,将54例患儿分为托拉塞米组、呋塞米加口服补钾组、呋塞米组各18例。三组患儿在激素及一般治疗的基础上,托拉塞米组给予静脉注射托拉塞米1 mg/(kg·d),每次不超过20 mg;呋塞米加口服补钾组给予静脉注射呋塞米2 mg/(kg·d),每次不超过40 mg,并口服补钾;呋塞米组给予静脉注射呋塞米2 mg/(kg·d),每次不超过40 mg。三组患儿分别于治疗前1 d、治疗后每天记录24 h尿量,治疗前及治疗后第4天抽外周血查电解质的变化情况,并记录不良反应。结果:三组患儿治疗后尿量较治疗前均显著增多,但治疗后前3 d平均尿量三组比较差异无统计学意义(P>0.05);呋塞米组治疗后第4天血钾浓度较其余两组降低明显(P<0.05);托拉塞米组和呋塞米加口服补钾组患儿治疗后第4天血钾浓度比较差异无统计学意义(P>0.05)。结论:临床上对于儿童肾病综合征引起的水肿应用托拉塞米或呋塞米治疗效果显著。应用呋塞米时同时口服补钾可减轻其致低血钾的不良反应。
Objective: To observe the clinical efficacy of torsemide and furosemide in treating nephrotic syndrome induced edema in children. Methods: Fifty-four children with nephrotic syndrome were enrolled in this study. Totally 54 children were divided into torsemide group, furosemide plus oral potassium group and furosemide group. Three groups of children on the basis of hormones and general treatment, torasemide group given intravenous injection of torsemide at 1 mg / (kg · d), each not more than 20 mg; furosemide plus oral potassium group Intravenous injection of furosemide 2 mg / (kg · d), each not more than 40 mg, and oral potassium; furosemide group given intravenous furosemide 2 mg / (kg · d), each not more than 40 mg. The three groups of children were treated 1 d before treatment, 24 h urine output after treatment recorded every day, before treatment and 4 days after treatment, check the electrolyte changes in peripheral blood and record adverse reactions. Results: The urinary volume of the three groups of children after treatment was significantly higher than that before treatment, but the average urine volume in the first 3 days after treatment was not significantly different among the three groups (P> 0.05). The blood of the fourth day after the furosemide treatment (P <0.05). Compared with the other two groups, the concentration of potassium in the torasemide group and the furosemide plus potassium group had no significant difference on the 4th day after treatment (P> 0.05). Conclusion: The clinical application of torasemide or furosemide in children with nephrotic syndrome caused by edema is effective. Application of furosemide while oral potassium can reduce the adverse effects of hypokalemia.