低分子右旋糖酐联合呋塞米治疗肾病综合征水肿的疗效观察

目的观察低分子右旋糖酐联合呋塞米对原发性。肾病综合征患儿的利尿作用。方法采取自身对照方法，对2008年1月至2008年12月在中山大学附属第一医院就诊的74例原发性肾病综合征患儿先后给予生理盐水联合呋塞米、低分子右旋糖酐联合呋塞米进行利尿治疗，观察比较两种利尿方法的效果。结果患儿使用低分子右旋糖酐联合呋塞米时的24h尿量、尿钠和尿钾多于生理盐水联合呋塞米时，24h尿量尤为显著（P〈0．05）；在静脉滴注低分子右旋糖酐联合呋塞米的过程中有12例患儿出现血压升高，其中7例出现高血压，所有血压升高者在停药后血压均可自行恢复正常，有1例患儿出现过敏反应。结论低分子右旋糖酐联合呋塞米能快速、有效地治疗肾病综合征患儿水肿，但需注意监测血压变化和防治过敏反应。

Clinical observation on low molecule dextran and furosemide treating for edema in children with nephrotic syndrome

Objective To observe the edema variation in patients with primary nephrotic syndrome treated with low molecule dextran/furosemide. Methods Seventy four pediatric patients with primary nephrotie syndrome in the First Affiliated Hospital of Sun Yat-sen University were enrolled, and they were treated with isotonic Na chloride/furosemide and low molecule dextraan/furosemide sequencely. A self-control study was conducted. Results The urinary volume, urinary sodium and urinary potassium of patients during low molecule dextran/furosemide infusion were more than those of patients during isotonic Na chloride/furosemide infusion, especially urinary volume（P 〈0. 05 ）. In course of intravenous infusion of low molecule dextran/furosemide, blood pres sure of 12 patients elevated, in which 7 patients were diagnosed hypertension, while the blood pressure back to normal after drug withdrawal. One patient appeared allergic reaction during infusion of low molecule dextran/ furosemide. Conclusion It was effective that treating primary nephrotie syndrome patients with low molecule dextran/furosemide, while blood pressure variation and allergic reaction need to be monitored and prevented.