【摘要】 目的观察低分子右旋糖酐加呋塞米治疗肾病综合征患儿伴重度水肿的利尿疗效,并与白蛋白加呋塞米的疗效作比较。方法将92例初次诊断为肾病综合征的患儿随机分为治疗组(A组)和对照组(B组),每组各46例。两组均给予抗凝、防治感染、纠正水电解质紊乱等常规治疗,A组再给予低分子右旋糖酐(10~15ml/kg.次)加呋塞米1~2 mg/kg.次,静脉缓慢推注,每天1次;B组给予静滴人血白蛋白(1g/kg.次)后推注呋塞米(剂量同A组),每天1次;均为7天。观察两组患者尿量变化情况、水肿消退时间、血清白蛋白变化及停药后水肿复发、利尿消肿所花的费用等情况。结果两组各项指标比较,尿量变化情况、水肿消退时间和血清白蛋白变化情况均无显著差异(P>0.05);停用利尿药后A组水肿复发率明显低于B组(P<0.05),A组利尿消肿所用的费用明显少于B组,差异均有统计学意义(P<0.005)。结论低分子右旋糖酐和呋塞米联合治疗小儿肾病综合征重度水肿,可以取得与人血白蛋白加呋塞米一样的利尿疗效,而且减少了复发,减少了费用,更加经济实用,值得临床推广应用。更多还原

【Abstract】 Objective To observe the clinical effect of low molecule dextran and furosemide on severe edema in children with nephrotic syndrome.Methods 92 children with nephrotic syndrome were randomly divided into 2 groups,including therapy group(Group A) and control group(Group B).On the basis of general therapy,patients in Group A were injected furosemide after low molecule dextran administration for seven days.Patients in Group B were treated with albumin and furosemide for seven days.The volume of urine,the time for edema subsidence,the serum levels of albumin and,the ratio of relapse of edema after drug withdrawal and the cost for edema treatment were observed.Results There were no distinct differences in the variation of urine,the time for edema subsidence and the serum levels of albumin between Group A and Group B(P>0.05).There were marked differences in the ratio of relapse of edema after drug withdrawal and the cost for edema treatment between Group A and Group B(P<0.05).Conclusion Low molecule dextran bound with furosemide could achieve the same diuretic effects as albumin bound with furosemide on severe edema in children with nephrotic syndrome.Moreover,it could decrease obviously the ratio of relapse of edema after drug withdrawal and the cost for edema treatment.更多还原