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目的比较限钠与不限钠对肝硬化腹水消退的影响。方法将80例肝硬化腹水患者随机分为两组:不限钠饮食组40例。限钠饮食组40例。在治疗前、治疗后分别测定血钠,血氯,尿钠,尿氯,尿量,比较腹水消退情况。结果治疗15d后补钠组血钠、血氯及尿钠、尿氯、尿量较治疗前增加,且高于限钠组治疗15d后水平;限钠组治疗15d后血钠、血氯较治疗前降低,尿钠、尿氯较治疗前稍有增加,尿量较治疗前稍有增加,限钠组治疗后诱发肝性脑病11例,明显高于补钠组3例;限钠组诱发肾功损害13例,明显高于补钠组2例。至出院时补钠组腹水消失29例,多于限钠组13例;补钠组腹水消失时间短于限钠组。结论肝硬化腹水患者在使用利尿剂的同时不应限钠饮食,以防低血钠而影响利尿剂效果,影响腹水消退,并能防止低血钠诱发肾功能损害,改善预后。
Objective To compare the effects of sodium restriction and sodium restriction on regression of ascites in cirrhosis. Methods Eighty cirrhotic patients with ascites were randomly divided into two groups: 40 patients in the sodium-free diet group. Limit sodium diet group of 40 cases. Before treatment, after treatment were measured sodium, blood chlorine, urine sodium, urine chlorine, urine output, compared ascites regression. Results Serum sodium, blood chlorine, urinary sodium, urinary chlorine and urine volume in sodium supplement group increased 15 days after treatment, and were higher than those in sodium restriction group after 15 days of treatment. After sodium 15 mg sodium chloride treatment, Before treatment, urinary sodium and urinary chlorine slightly increased compared with those before treatment. Urine volume increased slightly compared with that before treatment. Eleven patients with hepatic encephalopathy were induced in sodium restriction group, which was significantly higher than sodium supplementation group (n = 3) Power damage in 13 cases was significantly higher than sodium supplementation in 2 cases. To discharge sodium group ascites disappeared in 29 cases, more than limited sodium group of 13 cases; sodium group ascites disappeared shorter than sodium group. Conclusions Patients with cirrhosis and ascites should not restrict sodium diet while using diuretics, in order to prevent hyponatremia and affect diuretic effect, affect ascites extinction, and prevent hyponatremia-induced renal dysfunction and improve prognosis.