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。 Objective To understand the effects of diuretic therapy while not limited to sodium diet on the status of patients with advanced schistosomiasis (late blood) ascites. Methods Eighty patients with comparable grade of Childpough liver cirrhosis with ascites were divided into four groups: sodium-free diet group and sodium-limited diet group, 40 cases in each group. Serum sodium, blood chlorine and renal function were measured before treatment and 3, 7 and 14 days after treatment. Urine volume, fatigue, bloating and mental status were recorded every day. The regression of ascites on 10 d and 20 d was examined. Results After 2 weeks of treatment, the sodium in the sodium diet group was almost normal, the renal function was not damaged, the loss of appetite and fatigue were obviously improved, the time of ascites extinction was shortened, and no hypertonic sodium chloride solution was given due to severe hyponatremia. However, the sodium-limiting diet group mostly showed the opposite result. Conclusions Patients with late-stage ascites have better curative effect than those with sodium-only diet without restriction on diuretics. Recommendations Child pough grade A, B patients with non-refractory ascites late blood, the use of diuretics can use conventional sodium-containing diet.