连续性肾脏替代治疗预防急性动脉闭塞术后并发肌病肾病代谢综合征  

Prevention of myonephropathic metabolic syndrome after operation of acute arterial occlusion by continuous renal replacement therapy

作　　者：李艳[1] 沈波[1] 张薇[1] 

机构地区：[1]上海交通大学医学院第九人民医院肾内科,上海200011

出　　处：《上海交通大学学报（医学版）》2008年第4期438-440,共3页Journal of Shanghai Jiao tong University:Medical Science

摘　　要：目的探讨连续性肾脏替代治疗(CRRT)在预防急性动脉闭塞术后并发肌病肾病代谢综合征(MNMS)的作用。方法收集24例急性动脉闭塞住院患者,随机分成CRRT组(n=11)和对照组(n=13)。两组患者均行取栓或血管重建术。对照组术后常规抗感染、补充血容量、抗凝、纠正酸中毒及水、电解质紊乱;CRRT组在常规治疗基础上,在术中予连续性静脉静脉血液滤过(CVVH)模式治疗6 h,术后继续连续性血液净化24 h。结果对照组术后24 h的血钾、血尿素氮、血肌酐、血肌红蛋白浓度均明显高于CRRT组,血碳酸氢根浓度低于CRRT组(均P<0.05)。CRRT组MNMS发生率、截肢率和死亡率均低于对照组(P<0.05)。结论CRRT能有效预防急性动脉闭塞术后MNMS的发生,降低患者的截肢率和死亡率。Objective To study the effect of continuous renal replacement therapy（CRRT） in preventing myonephropathic metabolic syndrome（MNMS） after operation of acute arterial occlusion. Methods Twenty-four patients with acute arterial occlusion were divided randomly into 2 groups： CRRT group（n=11） and control group（n=13）.The patients were treated with embolectomy or revascularization.In control group,we used conventional therapy such as anti-inflammation,expansion of blood capacity,anticoagulation,and correcting acidosis and electrolyte disorder.In CRRT group,patients were treated by continuous veno-venous hemofiltration（CVVH） with 6 h during operation and 24 h after operation. Results In control group,24 h after operation,the serum potassium,blood urea nitrogen（BUN）,serum creatinine（SCr）,and myoglobin（Mb） were significantly increased（P〈0.05）,while the level of HCO3 was lower than CRRT group（P〈0.05）.The incidence of MNMS,amputation rate and the mortality of CRRT group were significantly lower than control group（P〈0.05）. Conclusion CRRT can effectively prevent the incidence of MNMS after operation of acute arterial occlusion,and decrease the amputation rate and the mortality.

关 键 词：肌病肾病代谢综合征 急性动脉闭塞 连续性肾脏替代治疗 急性肾衰竭 

分 类 号：R543[医药卫生—心血管疾病]