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目的探讨托伐普坦治疗肝硬化失代偿期患者稀释性低钠血症的疗效和安全性。方法选取2011年1月至2014年11月我院收治的112例失代偿性肝硬化稀释性低钠血症患者作为研究对象,采用随机数字表法将所选患者分为研究组和对照组,每组56例。对照组给予常规综合治疗,研究组在对照组的基础上加用托伐普坦口服治疗,综合比较两组患者血Na+浓度、血K+浓度、肝功能及不良反应情况。结果治疗3、5、7 d后,研究组血Na+浓度均高于对照组(P<0.05);治疗后两组患者血K+浓度、TBil、ALT均优于治疗前,但组间比较差异无统计学意义(P>0.05);两组患者均无严重不良反应发生(P>0.05)。结论托伐普坦治疗失代偿性肝硬化稀释性低钠血症患者效果确切,能有效提高血清Na+浓度,减少体液潴留,明显改善预后,值得临床推广使用。
Objective To investigate the efficacy and safety of tolvaptan in the treatment of patients with decompensated cirrhosis and hyponatremia. Methods One hundred and twelve patients with decompensated cirrhosis and diluted hyponatremia admitted from January 2011 to November 2014 in our hospital were selected as research objects. The patients were divided into study group and control group by random number table method , 56 cases in each group. The control group was given conventional comprehensive treatment. The study group was given oral treatment with tolvaptan on the basis of the control group. The blood Na + concentration, blood K + concentration, liver function and adverse reactions were compared between the two groups. Results After 3, 5, and 7 days of treatment, the blood Na + concentration in the study group was higher than that in the control group (P <0.05). After treatment, the blood K + concentration, TBil and ALT in both groups were better than those before treatment, but there was no significant difference between the two groups Statistical significance (P> 0.05); No serious adverse reactions occurred in both groups (P> 0.05). Conclusions Tolvaptan is effective in the treatment of patients with decompensated cirrhosis and hyponatremia. It can effectively increase serum Na + concentration, reduce fluid retention and significantly improve prognosis. It is worthy of clinical promotion.