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目的 :对血浆钠 <130mmol·L-1,利尿剂作用减弱 ,腹水消失时间延长的 5 6例肝硬化腹水病人 ,静脉补充 3%氯化钠(NaCl) ,观察利尿剂作用的效果。方法 :根据血浆钠检测结果及尿量变化 ,日补充 3%NaCl 30 0ml,连续使用 1～ 7d ,平均每人输注 45 5 .8ml。结果 :输注 3%NaCl后 6h尿量开始增加 ,2 4h增加 5 0 0～ 15 0 0ml,利尿剂作用明显增强 ,腹水消失时间缩短 ,与对照组相比差异具有显著性 (P <0 .0 1)。结论 :血浆钠 <130mmol·L-1时利尿剂作用明显减弱 ,血浆钠越低 ,利尿剂作用越弱。应用利尿剂时应注意NaCl的补充
Objective: To observe the effect of diuretic on intravenous 5% sodium chloride (NaCl) in 56 patients with cirrhosis and ascites whose plasma sodium <130mmol·L-1, diuretic effect weakened and ascites disappeared for a long time. Methods: According to the results of plasma sodium test and urine volume changes, daily supplementation of 30% NaCl 30 0ml, continuous use of 1 ~ 7d, the average infusion of 455.8ml per person. Results: The amount of urine began to increase at 6h after infusion of 3% NaCl, and increased from 500 to 150 ml at 24 hours. The diuretic effect was significantly enhanced and the disappearance time of ascites was shortened. The difference was significant compared with the control group (P <0. 0 1). Conclusion: The effect of diuretic on plasma sodium <130mmol·L-1 is obviously weakened. The lower the plasma sodium, the weaker the diuretic effect. When using diuretics should pay attention to the supplement of NaCl