特利加压素治疗肝叶切除术后肝肾综合征的疗效分析

目的分析特利加压素治疗肝叶切除术后肝肾综合征（HRS）的临床疗效。方法42例患者分为A组和B组，在综合治疗的基础上，A组给予利尿合剂和白蛋白治疗，B组给予特利加压素和白蛋白治疗，疗程均为7d。治疗期间观察患者一般临床症状、尿量、血清尿素氮和肌酐以及并发症等指标。结果疗程结束后，A组尿量治疗前为（663±249）ml／d，治疗后为（987±354）ml／d，差异有统计学意义（P〈0．05），尿素氮和肌酐较治疗前有所下降，但差异无统计学意义（P〉0．05）；B组尿量治疗前为（598±324）ml／d，治疗后为（1956±875）ml／d，尿素氮由（19．4±5．8）mmol／L下降至（10．5±4．3）mmol／L，肌酐由（231．2±69．8）μmol／L下降至（128．9±35．2）μmol／L，治疗前、后差异均有统计学意义（P〈0．05）；治疗前两组的尿量、尿素氮和肌酐差异无统计学意义（P〉0．05），治疗后与A组比较，B组变化更明显，差异有统计学意义（P〈0．05）；两组的并发症差异无统计学意义。结论特利加压素治疗肝叶切除术后HRS优于常用的利尿合剂，具有良好的疗效。

Therapeutic efficacy of terlipressin for hepatorenal syndrome after liver lobectomy

Objective To analyze the clinical therapeutic efficacy of terlipressin in management of hepatorenal syndrome （ HRS ） after liver lobectomy. Methods Forty - two patients were divided into group A and group B. Based on comprehensive treatment,traditional diuresis drug,dopamine and albumin were used in group A,while terlipressin and albumin were used in group B. Duration of treatment was 7 days in both groups A and B. The common clinical symptoms,urine output,blood urea nitrogen and creati- nine, complications were observed during treatment. Results After the treatment, the urine output, from （663 ± 249 ） to （987 ± 354） ml/24 h, was increased significantly （ P 〈 0.05 ） and the blood urea nitrogen and creatinine were decreased but there was no significant difference in group A（P 〉0.05 ）. In group B, the urine output, from （ 598 ± 324 ） to （ 1956 ± 875 ） mL/24 h, was increased significantly （ P 〈 0.05 ）, and both blood urea nitrogen from （ 19.4 ± 5.8 ） to （ 10.5 ± 4.3 ） retool/l, and creatinine from （ 231.2 ± 69.8 ） μmol/L to（ 128.9 ± 35.2 ）μmol/L were decreased sigrfifieantly（ P 〈 0.05 ）. There was no statistically sig- nificant difference between groups A and B in urine output,blood urea nitrogen and ereatinine（P 〉0.05） before treatment,but the efficacy index of group B was better than that of group A after treatment （P 〈 0.05 ）. There was no significant difference in complications between groups A and B （ P 〉 0.05）. Conclusion Compared with traditional diuresis drug and dopamine,terlipressin is more effective on HRS.