【Abstract】 Objective To investigate tolvaptan treatment of decompensated cirrhosis refractory ascites with different complications in patients with clinical efficacy and safety.Methods From June 2012 to May 2016,45 patients of cirrhosis with refractory ascites were selected as the research objects. The patients were treated with general treatment based on tolvaptan. The abdominal circumference, urine volume, body weight, edema and adverse events were observed. Results The weight, abdominal circumference,urine volume and edema of 37 cases improved. The efficiency rate was 82.2%. Tthe abdominal circumference, urine volume, body weight and edema were obviously improved in 23 cases. The effective rate reached 51.7% (P < 0.05). The patients with refractory ascites of cirrhosis with liver cancer were invalid. The effective rate patients with cirrhosis and refractory ascites with liver and kidney syndrome was 11.1% (5/45). The incidence of hyponatremia was 40.0% (18/45).Conclusion Tolvaptan has the effect of increasing diuresis in the treatment of refractory ascites during cirrhosis