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目的研究肝硬化腹水合并低钠血症患者的临床治疗。方法 85例消化内科收治的肝硬化腹水合并低钠血症患者,随机分为研究组(43例)和对照组(42例)。研究组患者在此基础上严格控制入水量并限制钠盐的摄入,对照组患者给予正常含钠饮食,血清钠≤120 mmol/L者给予3%氯化钠溶液静脉滴注治疗3~7 d,血清钠120~130 mmol/L者给予口服氯化钠溶液2次/d。对两组患者均给予2周的常规治疗,治疗后观察两组患者的临床疗效和肝性脑病、肝肾综合征及消化道出血等相关并发症发生情况。结果研究组患者的治疗总有效率为95.35%,明显高于对照组73.81%,差异具有统计学意义(P<0.05);研究组患者肝性脑病(4.65%)、肝肾综合征(2.33%)及消化道出血(23.26%)均低于对照组(26.19%、16.67%和52.38%),差异均具具有统计学意义(P<0.05)。结论对于肝硬化腹水患者在临床治疗过程中应该加强病情的监测,避免患者发生低钠血症,对于肝硬化腹水合并低钠血症的患者应在控制原发病的基础上,积极应用钠盐治疗,纠正低钠血症,促进患者疾病康复。
Objective To study the clinical treatment of patients with cirrhosis and hyponatremia. Methods Eighty-five patients with cirrhosis and hyponatremia admitted to Department of Gastroenterology were randomly divided into study group (43 cases) and control group (42 cases). On the basis of this, patients in the study group strictly controlled the amount of water infused and restricted the intake of sodium. The patients in the control group were given normal sodium diet. Patients with serum sodium ≤120 mmol / L were treated with intravenous infusion of 3% sodium chloride solution for 3 to 7 d, serum sodium 120 ~ 130 mmol / L were given oral sodium chloride solution 2 times / d. Two groups of patients were given routine treatment for two weeks. After treatment, the clinical efficacy and the incidence of hepatic encephalopathy, hepatorenal syndrome and gastrointestinal bleeding were observed. Results The total effective rate of study group was 95.35%, which was significantly higher than 73.81% of control group (P <0.05). The study group had hepatic encephalopathy (4.65%), hepatorenal syndrome (2.33% ) And gastrointestinal bleeding (23.26%) were lower than the control group (26.19%, 16.67% and 52.38%, respectively), the differences were statistically significant (P <0.05). Conclusion Ascites in patients with cirrhosis should be monitored during the clinical course of treatment to prevent patients with hyponatremia, cirrhosis and hyponatremia in patients with asymptomatic control of primary disease should be based on the active use of sodium Treatment, to correct hyponatremia, to promote the recovery of patients with diseases.