连续性肾脏替代疗法联用贺斯临床疗效观察  

Clinical effects of continuous renal replacement therapy and HAES-steril on hemodynamics,renal function and biochemistry values of critical care patients

作　　者：王可富[1] 翟茜[1] 钟宁[2] 李琛[1] 陈晓梅[1] 张蔚[1] 李金花[1] 冯思红[1] 

机构地区：[1]山东大学齐鲁医院ICU [2]山东大学医学院诊断研究所

出　　处：《山东大学学报（医学版）》2003年第6期667-669,672,共4页Journal of Shandong University:Health Sciences

摘　　要：目的:探讨连续性肾脏替代疗法联合应用贺斯在心肺复苏术后发生肾前性肾功能衰竭及部分水肿合并胸腔积液的危重病人中的应用价值;方法:25例心肺复苏术后发生肾前性肾功能衰竭和24例水肿合并胸腔积液的危重病人接受连续性肾脏替代疗法,前稀释法输入置换液,治疗过程中联合应用贺斯,观察治疗前后心率、血压、生化指标、肾功能、升压药用量、临床症状体征及胸片的变化,观察上述治疗方案的临床疗效;结果:心肺复苏组25例患者平均治疗(45.2±8.7)小时,经治疗后尿素氮、肌酐、血清钾水平明显下降,差异有显著性(P<0.05)。治疗前后心率、血压变化不明显,多巴胺用量下降(P<0.05)。低蛋白血症组24例患者平均治疗(24.7±6.9)小时,治疗前后心率、血压、生化指标变化不明显,治疗后临床症状明显改善,复查胸片胸水减少,有效率100%;结论:危重患者应用连续性肾脏替代疗法联用贺斯可以有效改善血流动力学,促进肾功能恢复,纠正高血钾;同时能清除患者体内多余的水分,不会导致生化指标的异常。Objective:To investigate the cli ni cal application value of continuous renal replace-ment therapy(CRRT)and HAES-steril in treating post-cardiopulmonary resuscitation patients suffering from pre-renal dysfunction and hypoproteinemia patients suffering from edema and h ydrothorax.Meth-ods:Twenty-five post-cardiopulmonary resuscitation patients with pre-renal dysfunction(group1)and24hypoproteinemia patients with edem a and hydrothorax (group2)were treated with CRRT and HAES-steril,and the h eart rate,blood pressure,renal function,biochemistry values,clinical symptom and sign,dose of dopamine,and chest sheet were observed before and after trea tment.Results:The treat-ment time of the two groups was(45.2±8.7 )and(24.7±6.9)hours.BUN,Cr,potassium concentrations and dopamine d ose decreased distinctly (P<0.05),while heart rate and blood pressure ha d no distinct change after being treated with CRRT and HAES-steril in group1. The clinical symptoms and signs of group2improved significantly after being tr eated with CRRT.Conclusion:CRRT and HAES-steril can improve hemodynamics and renal function,redress hyperkalemia,remove supernumerary water without influe nce on biochemistry values.

关 键 词：肾替代疗法 血液滤过 贺斯 

分 类 号：R586.9[医药卫生—内分泌]