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目的:观察托伐普坦治疗恶性腹腔积液合并低钠血症患者后的血钠及24 h尿量等指标变化。方法:38例恶性腹腔积液合并低钠血症患者随机分为观察组和对照组,对照组给予常规利尿处理,观察组在常规治疗基础上联用托伐普坦片,治疗7 d后,比较两组患者治疗前后血钠、24 h尿量、腹围及体重等指标的变化,并观察治疗期间两组不良反应发生情况。结果:治疗后观察组的血钠水平较治疗前显著升高(P<0.01),治疗后两组24 h尿量均较治疗前增多(P<0.01),且治疗后观察组24 h尿量明显高于对照组(P<0.01)。观察组4例患者出现口干不适,两组间差异无统计学意义,治疗期间两组患者均未出现严重不良反应。结论:托伐普坦治疗恶性腹腔积液合并低钠血症患者的疗效确切,可以改善患者的生存质量,且安全可靠。
Objective: To observe the change of serum sodium and 24-hour urine output after treatment with tolvaptan in patients with malignant ascites and hyponatremia. Methods: Thirty-eight patients with malignant ascites and hyponatremia were randomly divided into observation group and control group. The control group was given routine diuretic treatment. The observation group was treated with tolvaptan tablet on the basis of routine treatment. After 7 days of treatment, The changes of serum sodium, 24-hour urine volume, abdominal circumference and body weight before and after treatment were compared between the two groups. The incidence of adverse reactions in the two groups was also observed. Results: After treatment, the level of serum sodium in the observation group was significantly higher than that before treatment (P <0.01). The urine output of 24 h after treatment in both groups increased more than that before treatment (P <0.01) Obviously higher than the control group (P <0.01). In the observation group, 4 patients experienced dry mouth discomfort, with no significant difference between the two groups. No serious adverse reactions occurred in both groups during the treatment period. Conclusion: The efficacy of tolvaptan in the treatment of patients with malignant ascites and hyponatremia is accurate, which can improve the quality of life of patients and is safe and reliable.