不同血液净化方法治疗重症急性肾衰的临床疗效观察  

Clinical study of different blood purification methods in treatment of severe acute renal failure.

作　　者：钟鸿斌[1] 黄硕[2] 廖爱能[1] 丁珊珊[1] 陈文[1] 谢桂芳[1] 刘宝莲[1] 

机构地区：[1]福建省三明市第二医院肾内科,366000 [2]福建省三明市第二医院麻醉科,366000

出　　处：《中国医药》2007年第11期674-676,共3页China Medicine

摘　　要：目的观察床边急诊插管腹膜透析(PD)和连续性肾脏替代治疗(CRRT)对于重症急性肾功能衰竭(ARF)患者的疗效。方法分析33例重症急性肾衰竭患者采用PD和CRRT治疗的疗效,其中行床边急诊插管行PD者17例,CRRT者16例。观察患者血液净化前后连续5d血肌酐(Scr)、尿素氮(BUN)、钾(K^+)、二氧化碳结合力(CO_2CP)水平的变化,预后,平均每日透析费用。结果血液净化前后连续5d血BUN、Scr、K^+、CO_2CP的变化并无差异(P>0.05)。2组患者中肾功能恢复及存活者所占比例无显著性差异(P>0.05)。但CRRT组患者平均每日透析费用为(3220.94±95.32)元,明显高于PD组的(619.27±108.90)元(P<0.01)。结论床边急诊插管PD与CRRT均是治疗重症急性肾衰竭的有效方法,但床边急诊插管PD是一种安全、简单、经济的方法。Objective To compare the effect of peritoneal dialysis （PD） by bedside intubation and continuous renal replacement therapy（CRRT） on severe acute renal failure（ARF）. Methods 33 cases with severe ARF were studied, among whom 17 patients were treated with PD by bedside intubation and 16 patients were treated with CRRT. Biochemistry index including Scr, BUN, K^＋, and CO2CP, dialysis expense per day were all recorded. Results There were no differences in serum biochemistry between 2 groups （P 〉 0. 05）. No difference was found in the incidence of renal recovery and patient mortality between 2 groups （P 〉 0. 05）. However, dialysis expense per day were （619. 27 ± 108. 9 ）yuan in PD patients by bedside intubation, which were lower than （3220. 94± 95.32）yuan in CRRT patients （P 〈 0. 01 ）. Conclusion PD patients by bedside intubation and CRRT have the same effect on severe ARF. However,PD patients by bedside intubation is safe, simple and economic.

关 键 词：急性肾功能衰竭 腹膜透析 连续性肾脏替代治疗 

分 类 号：R692.5[医药卫生—泌尿科学]