ABSTRACT
Objective To investigate the efficacy and safety of adjusting the doses of diuretics of different time in the treat-ment of advanced schistosomiasis ascites. Methods A total of 80 advanced schistosomiasis patients with ascites were randomly divided into an observation group and a control group(40 cases each). The patients in the observation group received spironolac-tone and furosemide,and the first doses were 100 mg/d and 40 mg/d,respectively. If the efficacy was poor,according to the first doses of the standard increments once every four days,the doses gradually increased to the maximum doses of spironolactone 400 mg/d and furosemide 160 mg/d,respectively. The patients in the control group received spironolactone and furosemide,and the first doses were the same as those of the observation group. If the efficacy was poor,according to the first doses of the standard in-crements once every seven days,the doses gradually increased to the maximum doses as those of the observation group. Other con-ventional treatments were the same in both groups. Results In both groups,the reductions of the total amount of the weight were (5.62±1.28)kg and(5.42±1.37)kg respectively;the time of efficacy beginning was(3.84±2.36)days and(4.65±2.86)days re-spectively;the average daily amounts of weight loss were(0.41 ± 0.16)kg and(0.35 ± 0.11)kg respectively;the efficient rates were 95%and 92.5%respectively;and there were no significant differences between the two group(all P>0.05). However,the time of reduction from moderate ascites to mild ascites was(10.70±3.01)days(6-20 days)in the observation group and the time was(14.75±5.62)days(7-30 days)in the control group(u=3.876,P<0.01). Conclusion The therapy of diuretic doses ad-justed by a four-day cycle is more useful for advanced schistosomiasis patients with ascites.
ABSTRACT
Objective To study the clinical characteristics of early esophageal varices bleeding after endoscopic varices liga-tion EVL in advanced schistosomiasis patients. Methods The data of 206 advanced schistosomiasis patients who received VEL were collected and studied retrospectively. Results There were 17 cases of early esophageal varices bleeding after EVL in-cluding 1 died case the early hemorrhage rate was 8.25% and the mortality rate was 0.5%. The early bleeding occurred from the 4th to 12th day and 76%occurred from the 7th to 9th day postoperatively. The direct cause of hemorrhagic was ligation ring falling off and the inducements were the improper diet 10 cases 58.8% and increased abdominal pressure 6 cases 35% . All the cases of early esophageal varices bleeding occurred in the patients whose liver function being Child-Pugh C. Conclu-sions The incidence and mortality of EVL early postoperative hemorrhage are both low and mostly occur from the 7th to 9th day postoperatively. We should pay attention to the diet and nursing and the patients with Child-Pugh C liver function are the high risk group.