托拉塞米治疗恶性腹水临床疗效观察

摘要

Objective]To observe the efficacy and safety of torasemide in the patients with malignant as-cites.[Methods]Total 178 patients with malignant ascites were randomly divided into treatment group and control group.Torasemide(40 mg po qd)was given to the treatment group ,furosemide(80 mg po qd)and spironolactone(200 mg po qd)were given to the control group for 2 weeks.The variety of urine volume ,ab-dominal perimeter ,serum potassium level and blood uric acid were detected.[Results]Urine volume of pa-tients in the two groups after treatment significantly increased (P<0.01).Urine volume in the treatment group increased to 754.3 ± 522.7 ml/24 h ,which was significantly higher than that in the control group (364.8 ± 465.2)ml/24 h(P<0.05).The abdominal perimeter in two groups was significantly decreased (P< 0.01).There was significant difference between the groups (P< 0.01).The overall effective rate in the treatment group was 77.17% ,which was significantly higher than that in control group (47.67% ,P<0.01).After treatment there were no changes in serum potassium and uric acid level in treatment group.The control group showed no change of serum potassium ,but patients had the acute hyperuricemia.[Conclusion]Torasemide is superior to furosemide plus spironolactone on both effect and safety in the treatment of malignant ascites.%[目的]观察托拉塞米治疗恶性腹水的临床疗效及其安全性。[方法]：将178例恶性腹水患者随机分为试验组和对照组，试验组口服托拉塞米片40 mg ，次/d；对照组口服速尿片80 mg＋安体舒通片200 mg ，次/d；2组均连用2周。观察2组患者治疗前后的尿量、腹围、血钾及血尿酸变化，评估总体疗效及安全性。[结果]2组患者治疗后的尿量均较治疗前明显增多，差异有统计学意义（ P＜0.01）；试验组尿量增加的幅度为（754.3±522.7）m l/24 h ，明显高于对照组的（364.8±465.2）m l/24 h （ P＜0.05）。2组患者治疗后的腰围均比治疗前明显缩小（ P＜0.01），且试验组缩小的程度明显大于对照组，其差异有统计学意义（ P＜0.01）。试验组的总体有效率（77.17％）显著高于对照组（47.67％），差异有统计学意义（ P＜0.01）。对照组治疗后无血钾降低，但出现高尿酸血症；试验组治疗后血钾及血尿酸均无明显改变。[结论]托拉塞米在治疗恶性腹水的疗效及安全性方面均明显优于传统的呋塞米＋安体舒通组合。