不限钠饮食加利尿剂治疗晚期血吸虫病腹水效果

目的了解使用利尿剂治疗的同时不限钠饮食对晚期血吸虫病(晚血)腹水患者病情的影响。方法将80例肝功能Child pough分级相当的晚血腹水患者分为不限钠饮食组和限钠饮食组,每组40例。治疗前及治疗后3、7、14 d测血钠、血氯、肾功能,每天记录尿量、乏力、腹胀、精神状况,10 d及20 d B超复查腹水消退情况。结果治疗后2周不限钠饮食组血钠基本正常,肾功能无损害,食欲不振及乏力明显改善,腹水消退时间缩短,无因严重低血钠补充高渗氯化钠液者。而限钠饮食组大多出现相反的结果。结论晚血腹水患者在使用利尿剂的同时不限钠饮食较限钠饮食患者疗效好。建议对Child pough分级为A、B级的非顽固性腹水晚血患者,在使用利尿剂时可采用常规含钠饮食。

Therapeutic effect of open-sodium diet and diuretics on treatment of advanced schistosomiasis patients with ascites

Objective To investigate the impact of diuretics combined with open-sodium diet on advanced schistosomiasis patients with ascites.MethodsA total of 80 cases were divided into two groups,namely open-sodium diet group and sodium-controlled diet group,each containing 40 cases.The blood sodium,blood chloride and renal function were determined pre-treatment and on 3,7 and 14 days post-treatment,and the urine volume,fatigue,abdominal distension and mental status were recorded everyday.The ascites subsiding was re-checked on day 10th and 20th using type-B ultrasonic test.ResultsTwo weeks after treatment,the blood sodium in the open-sodium diet group were almost normal,renal function was not damaged,loss of appetite and fatigue improved significantly and the time of ascites subsided was shortened.Nobody had to transfuse hypertonic saline of NaCl due to hyponatremia badly.However,most of the people in the control group had the opposite situation.ConclusionsThe therapeutic effect is better using diuretics combined with open-sodium diet than diuretics and sodium-controlled diet in treatment of advanced schistosomiasis patients with ascites.It is suggested that,for non-refractory advanced schistosomiasis patients with ascites,conventional diet containing sodium can be taken while using diuretics.