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目的探讨利尿剂不同时间调整剂量对腹水型晚期血吸虫病(晚血)的疗效及安全性。方法将80例腹水型晚血患者随机分为观察组和对照组,各40例。观察组患者接受螺内酯和呋塞米,首剂分别为100 mg/d和40 mg/d,若疗效不佳,按首剂量标准每4 d增量1次,逐渐增量至最大剂量螺内酯400 mg/d和呋塞米160 mg/d;对照组患者同样接受螺内酯和呋塞米,首剂与观察组相同,若疗效不佳时,则按首剂量标准每7 d增量1次,逐渐增量至与观察组相同的最大剂量。其他常规治疗2组相同。结果观察组和对照组患者平均体重减轻量为(5.62±1.28)kg和(5.42±1.37)kg,平均起效时间为(3.84±2.36)d和(4.65±2.86)d,平均每日体重减轻量为(0.41±0.16)kg和(0.35±0.11)kg,有效率为95.0%和92.5%,2组差异均无统计学意义(P均>0.05)。腹水从中度减至轻度所需时间观察组为(10.70±3.01)d,对照组为(14.75±5.62)d(u=3.876,P<0.01)。结论采用利尿剂治疗晚血腹水,以4 d为1个周期调整剂量为宜。
Objective To investigate the curative effect and safety of diuretic at different times on advanced ascites-type schistosomiasis (late blood). Methods 80 cases of ascites late blood were randomly divided into observation group and control group, 40 cases in each. The observation group received spironolactone and furosemide, the first dose of 100 mg / d and 40 mg / d, respectively, if the curative effect is not good, according to the first dose standard every 4 d increment 1, and gradually increased to the maximum dose of spironolactone 400 mg / d and furosemide 160 mg / d; control group patients also received spironolactone and furosemide, the first dose and observation group the same, if the curative effect is poor, then according to the first dose standard every 7 d increments, and gradually increased Amount to the same maximum dose as the observation group. Other routine treatment of the same two groups. Results The average weight loss of observation group and control group were (5.62 ± 1.28) kg and (5.42 ± 1.37) kg, respectively. The mean effective time was (3.84 ± 2.36) d and (4.65 ± 2.86) days, respectively. The average daily weight loss (0.41 ± 0.16) kg and (0.35 ± 0.11) kg respectively. The effective rates were 95.0% and 92.5%, respectively. There was no significant difference between the two groups (all P> 0.05). The time required for reducing ascites from moderate to mild was (10.70 ± 3.01) days in the observation group and (14.75 ± 5.62) days in the control group (u = 3.876, P <0.01). Conclusion Diuretic treatment of late ascites, to 4 d for a cycle to adjust the dose is appropriate.