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| 托伐普坦片治疗肝硬化腹水、低钠血症的效果及安全性 |
| Efficacy and safety of tolvaptan in treatment of cirrhosis patients with ascites and hyponatremia |
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| DOI：10.3969/j.issn.1007-8134.2021.03.011 |
| 中文关键词: 托伐普坦 低钠血症 腹水 肝硬化 |
| 英文关键词: tolvaptan hyponatremia ascites cirrhosis |
| 基金项目: |
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| 中文摘要: |
| 目的 评价在常规治疗基础上应用托伐普坦治疗肝硬化合并腹水、低钠血症的效果和安全性。方法 纳入2018年8月—2019年10月在我院治疗的30例肝硬化合并腹水、低钠血症患者，按照随机数字表法分为托伐普坦组（15例）和对照组（15例）。托伐普坦组患者在常规治疗基础上服用托伐普坦片，15 mg/d；对照组患者在常规治疗基础上给予输入托拉塞米注射液20 mg/d和（0.9%NaCl 100 ml+10%NaCl 30 ml）/d。观察2组患者体质量、尿液、腹围、血钠变化，记录不良反应发生情况，评估疗效及安全性。结果 治疗第7 d，托伐普坦组血钠升高幅度明显高于对照组（P＜0.05）。治疗第2 d，托伐普坦组尿量增加量明显高于对照组(P＜0.05)。部分患者出现口渴症状。结论 托伐普坦能有效纠正肝硬化腹水患者低钠血症，增加尿量，减少腹水量，耐受性良好，无严重不良反应。 |
| 英文摘要: |
| Objective To evaluate the efficacy and safety of tolvaptan based on conventional treatment in cirrhosis patients with ascites and hyponatremia. Methods Thirty cirrhosis patients with ascites and hyponatremia were enrolled from our hospital from August 2018 to October 2019 and randomly assigned to tolvaptan group(n=15) and control group(n=15). The patients in tolvaptan group received tolvaptan tablets 15 mg/d in addition to conventional treatment, while the patients in control group were given torasemide injection 20 mg/d and (0.9%NaCl 100 ml + 10%NaCl 30 ml)/d. The patients’ body weight, volume of urine, abdominal circumference and change of serum sodium were observed and adverse events were monitored, so as to evaluate the efficacy and safety. Results The increment of serum sodium was significantly higher in tolvaptan group than that in control group on 7 days after treatment (P＜0.05). In addition, the increasing volume of urine in tolvaptan group was significantly higher than that in control group on 2 days after treatment (P＜0.05). Some patients showed symptoms of thirst. Conclusions Tolvaptan can effectively correct hyponatremia, increase the volume of urine, reduce the volume of ascites in cirrhosis patients with ascites. It shows good tolerance and no serious adverse events. |
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