连续性血液净化与常规血透治疗乳酸酸中毒比较  

Comparison of continuous renal replacement therapy and regular hemodialysis in severe lactk acidosis therapy

作　　者：宋岩[1] 李冀军[1] 张壹言[1] 荆丹青 陈凤锟[1] 龚平[1] 

机构地区：[1]解放军304医院肾内科,北京100037 [2]解放军304医院内分泌科,北京100037

出　　处：《中国血液净化》2002年第6期7-9,共3页Chinese Journal of Blood Purification

摘　　要：目的 探讨乳酸酸中毒的血液净化方法。方法 回顾分析我院用持续性静静脉血液滤过(CVVH)和血液透析滤过(HDF)、血液透析(HD)救治的重症乳酸酸中毒的临床及实验室资料。结果 CVVH、HDF和HD治疗乳酸酸中毒疗效明确;HDF和HD对患者血氧分压和氧饱和度影响比CVVH大;CVVH时HCO_3^-浓度高对患者血氧分压、血氧饱和度影响大。结论 对乳酸酸中毒治疗CVVH优于HDF及HD疗法;CVVH时HCO_3^-浓度不宜太高;治疗中应注意胰岛素蓄积问题及补钾。Objective To investigate the dialysis therapy of lactic acidosis. Methods We analyzed the clinical and ' laboratory data of two severe lactic acidosis cases treated by continuous veno - venouse hemofiltration( CWH), hemodi-afiltration (HDF) and hemodialysis(HD). Results CVVH, HDF and HD showed definite effects on severe lactic acidosis. HDF and HD affected the partial pressure of oxygen and arterial oxygen saturation more than CWH. During CWH, high HCO3- concentration affected the partial pressure of oxygen and arterial oxygen saturation.Condusions As treatment to severe lactic acidosis, CWH is better than HDF and HD; HCO3- concentration shouldn't be too high dur-ing CWH. Attention should be taken to insulin accumulation and potassium comph'ment.

关 键 词：持续性静静脉血液滤过 血液透析滤过 血液透析 乳酸酸中毒 血气分析 

分 类 号：R45[医药卫生—治疗学]