不同血液净化方式治疗动物毒素导致急性肾损伤的临床研究  

A clinical study of different modes of blood purification on patients with animal toxins induced acute kidney injury

作　　者：周竹[1] 毕丹青[1] 韩冰冰[1] 白云楷[1] 

机构地区：[1]昆明医学院第一附属医院肾脏内科,云南昆明650032

出　　处：《中国当代医药》2011年第3期5-7,共3页China Modern Medicine

摘　　要：目的:观察不同血液净化方式对动物毒素导致急性肾损伤(AKI)预后的影响。方法:回顾性分析本科近6年来动物毒素导致急性肾损伤30例患者进行回顾性分析。连续性静脉静脉血液滤过(CVVH)联合间歇性血液透析(IHD)组15例,前期行CVVH治疗,3次后给予IHD治疗。血液灌流(HP)联合IHD组15例,采用HP治疗3次后给予IHD治疗。结果:①两组患者治疗前,肾功能[Scr(μmol/L)(1010.54±334.55)vs(1108.53±335.55);BUN(mmol/L)(33.54±6.25)vs(34.53±7.55)],差异无统计学意义,P>0.05,肝功能[ALT(IU/L)(1052.14±383.61)vs(992.44±333.21);AST(IU/L)(781.53±579.73)vs(852.14±483.01)],差异无统计学意义,P>0.05;hs-CRP(mg/L)[(45.23±7.58)vs(85.55±6.28)],差异有统计学意义,P<0.05。②两组患者治疗后,肾功能、肝功能、hs-CRP均恢复正常,治愈率为100%;两组患者进入多尿期时间(d)[(9.13±1.27)vs(10.23±1.23),差异无统计学意义,P>0.05;两组患者透析次数(次)[(7.12±2.22)vs(8.91±2.27)],差异无统计学意义,P>0.05。③两组患者治疗过程不良反应,低血压CVVH联合IHD组及HP联合IHD组各1例;高血压CVVH联合IHD组0例,HP联合IHD组1例;出血事件CVVH联合IHD组及HP联合IHD组各1例。结论:急性肾功能衰竭早期经CVVH联合IHD或者HP联合IHD两种抢救方式利于患者受损器官功能的恢复,提高患者的生存率。Objective：To investigate the effect of different modes of blood purification on prognosis of patients with animal toxins induced acute kidney injury.Methods：Thirty paients with animal toxins injury during six years were retrospectively analyzed.After administered blood purification,they were divided into two groups.CVVH combined IHD group（15 cas es）：early intervention with continuous veno-venous hemofiltration（CVVH） and then intermitent hemodialysis（IHD） when conditions of patients were stable.hemoperfusion（HP） combined IHD group（15 cases）,patients were performed three times with HP and then with IHD treatment.Results：①Before treatment in two groups,There were no significant differences of renal function and liver function,but there was significant differences of hs-CRP;②After administered blood purification in two groups,survival and clinical improvement rates were 100%.③Adverse reactions,low blood pressure in two groups one case respectively,and one case of high blood pressure in HP/IHD group,and haemorrhage in two groups one case re spectively.Conclusion：Early CVVH combined IHD or HP combined IHD treatment is useful in survival and clinical improvement rates.

关 键 词：动物毒素 急性肾损伤 连续性静脉静脉血液滤过 血液透析 血液灌流 

分 类 号：R692[医药卫生—泌尿科学]