盐酸米多君加常规药物治疗肝硬化顽固性腹水的临床疗效分析

目的 探讨盐酸米多君加常规药物（多巴胺注射液联合呋塞米注射液）对肝硬化顽固性腹水的治疗效果.方法 回顾性分析该院2008年10月-2012年10月间收治的60例肝硬化顽固性腹水的临床资料,将其随机分为治疗组与对照组,每组30例,治疗组患者在常规药物治疗基础上口服盐酸米多君2.5~7.5 mg/次,2~3次/d,对照组患者采用多巴胺注射液联合呋塞米注射液,1次/d,疗程3~5周.结果 经治疗后,治疗组患者尿量、尿钠排泄、平均动脉压、白蛋白显著升高,血浆肾素和醛固酮明显降低（P〈0.05）,在腹水控制情况方面治疗组明显优于对照组（P〈0.05）.结论 在行常规的利尿基础上口服盐酸米多君可改善肝硬化患者的血流动力学,且比较单独应用利尿药在控制腹水方面效果更显著,并对肝肾功能影响小.

Analysis of the Clinical Treatment Effect of Cirrhosis with Intractable Ascites by Midodrine Hydrochloride plus Conventional Medications

Objective To investigate the efficacy of midodrine hydrochloride plus conventional medications （dopamine hydrochloride injection and furosemide injection） in the treatment of cirrhosis with refractory ascites. Methods The clinical data of 60 cirrhosis patients with refractory ascites admitted in our hospital from October, 2008 to October, 2012 were collected and divided into treatment group and control group randomly, 30 cases in each group. Patients of the treatment group took midodrine hydrochloride orally, 2.5 -7.5 mg each dose, 2-3 times a day on the basis of conventional drug therapy, while the patients in the control group were administered with dopamine hydrochloride injection and furosemide injection once a day, for a course of 3 to 5 weeks. Results The urine volume, natriuresis, mean arterial pressure and albumin of the patients in the treatment group increased significantly after treatment while their plasma rennin and aldosterone decreased significantly （P〈0.05）. In terms of ascites volume control, patients in treatment group were superior to the patients in control group （P〈0.05）. Conclusion Oral medication with midodrine hydrochloride plus diuresis treatment can improve the hemodynamics of patients with cirrhosis, which is much more effective in the control of ascites compared with taking dieresis medication alone. And it has little damage to the hepatorenal function.