奥曲肽、米多君和白蛋白联合治疗肝硬化难治性腹水的疗效  

Efficacy of combined use of midodrine,octreotide and albumin in treating refractory ascites in patients with hepatocirrhosis

作　　者：彭宇华[1] 阿米娜.阿地力 朱东双 

机构地区：[1]广州医学院第三附属医院急诊内科,广东省510150 [2]新疆维吾尔自治区第一济困医院内科 [3]新疆维吾尔自治区疏附县人民医院内科

出　　处：《江苏医药》2012年第17期2031-2033,共3页Jiangsu Medical Journal

摘　　要：目的探讨奥曲肽、米多君和白蛋白联合用药对难治性腹水的治疗效果。方法肝硬化难治性腹水患者40例均分为两组。治疗组:皮下注射奥曲肽0.1mg,每日3次;口服盐酸米多君5mg,每日3次;静脉滴注25%白蛋白50g,每周3次。对照组:行常规利尿治疗。结果治疗组治疗后平均动脉压(96.2±3.7)mm Hg,门静脉主干内径(12.2±0.3)mm,醛固酮(752±138)pmol/L和肾素(89.2±23.4)ng/L,24-h尿钠(29.5±7.1)mmol/L。与治疗前和对照组治疗后比较,均有显著改善(P<0.05),腹水量显著减少(P<0.05)。结论奥曲肽、米多君和白蛋白的联合用药能显著减少肝硬化难治性腹水患者的腹水量,改善病情。Objective To investigate the efficacy of combined use of midodrine, octreotide and albumin in treating refractory ascites in patients with hepatocirrhosis. Methods Fourty patients were equally divided in two groups of A （treated with combined use of subcutaneous octreotide 0. 1 mg injection tid. oral midodrine 5 mg tid. and intravenous albumin 50 g 3 times per week） and B（treated with conventional diuresis）. The outcomes were compared at the end of 30 days treatment. Results After treatment in group A,the volume of ascites was reduced, the mean arterial pressure was （96.2i 3.7） mm Hg, the internal diameter of main portal vein was （ 12. 2 ± 0. 3） mm, plasma concentrations of aldosterone and renin were （752±138） pmol/L and （89.2±23. 4） ng/L, and 24-h urinary sodium was （29. 5±7. 1） mmol/L,which were all improved significantly compared to those before and those in group B after treatment （P〈0. 05）. Conclusion Combined use of midodrine, octreotide and albumin can effectively reduce the volume of ascites and improve the conditions of patients with hepatocirrhosis.

关 键 词：肝硬化腹水 奥曲肽 米多君 

分 类 号：R575[医药卫生—消化系统]