连续性静脉血液滤过治疗顽固性充血性心衰的疗效观察(14例临床分析)  

Continuous venovenous hemofiltration in patients with refractory congestive heart failure-an analysis of 14 cases

作　　者：于长青[1] 林洪丽[1] 王可平[1] 杭宏东[1] 秦凤绮[1] 贾乐文[1] 

机构地区：[1]大连医科大学第一临床学院肾内科,辽宁大连116011

出　　处：《大连医科大学学报》2005年第1期25-27,共3页Journal of Dalian Medical University

摘　　要：[目的 ]观察 14例顽固性充血性心衰病人用连续性静脉血液滤过治疗的效果。 [方法 ]所有病人治疗前、后测定肾功能 (BUN、Cre)、离子 (K+、Na+、Cl- )、左室射血分数 (LVEF) ,心胸比(HTR)。治疗过程中 ,监测平均压 (MBP)、心律、心率 (HR)变化。每天记录尿量。 [结果 ]14例病人全部存活 ,临床症状缓解。 5例病人肾功能完全恢复正常。治疗前后BUN2 8.7± 12 .89,10 .17± 5 .98,P <0 .0 1;Cre 336 .89± 5 6 .98,2 36 .33± 14 5 .2 9,P <0 .0 5 ;HTR 0 .6 2± 0 .0 7,0 .5 1± 0 .0 6 ,P <0 .0 5 ;LVEF 0 .4 3± 0 .11,0 .6 1± 0 .0 4 ,P <0 .0 5 ;尿量 (32 0± 14 0 )mL/ 2 4h ,(84 0± 2 80 )mL/2 4h ,P <0 .0 5。 [结论 ]CVVH能够平稳清除水及毒素并保持血流动力学稳定 ,是治疗顽固性心衰的有效方法。Objective To study the influence of continuous venovenuous hemofiltration on patients with refractory congestive heart failure. [Methods] The serum BUN, Cre, iron, left ventricle ejection fraction (LVEF), heart thorax ratio (HTR) were observed before and after the therapy. Blood pressure, arrhythmia, heart rate were monitored during the treatment and urinary volume was also recorded each day as well. [Results] Fourteen patients all survived and their clinical symptoms were improved. Renal function in 5 patients recovered completely. BUN and Cre all decreased compared to those before CVVH, respectively 28.7±12.89,10.17±5.98, P< 0.01; 336.89±56.98, 236.33±145.29, P<0.05. HTR decreased, 0.62±0.07 verse 0.51±0.06, P< 0.05 while LVEF and urinary volume increased 0.43±0.11 verse 0.61±0.04, P<0.05; (320±140) mL/24 h verse (840±280) mL/24 h, respectively. [Conclusion] CVVH can keep hemodynamics stable during removing excess water and toxin and it is an effective method to treat refractory congestive heart failure.

关 键 词：连续性静脉血液滤过 顽固性充血性心衰 治疗 

分 类 号：R541.6[医药卫生—心血管疾病]