持续低效血液透析与连续性血液净化在危重症患者治疗中的效果  

Compariron of the therapeutic effect between sustained low-efficiency dialysis （SLED） and continuous blood purification （CBP） in critically ill patients

作　　者：程骏章[1] 胡守亮[1] 卢宏柱[1] 莫继安[1] 艾俊英[1] 刘俊成[1] 袁凡丽[1] 陈蓉[1] 

机构地区：[1]长江大学附属第一医院肾内科,湖北省荆州434000

出　　处：《中华急诊医学杂志》2012年第8期874-877,共4页Chinese Journal of Emergency Medicine

摘　　要：目的比较持续低效血液透析（sustained low—efficiency dialysis，SLED）与连续性血液净化（continuous blood purification，CBP）在危重症患者治疗效果中的差异。方法将长江大学附属第一医院96例危重症患者按血液净化方式的不同分为连续性血液净化（CBP）组和持续低效血液透析（SLED）组，比较两种治疗方式治疗后各项生化指标、住院天数、血流动力学参数、急性生理学与慢性健康状况评分（acute physiology and chronic health evaluation，APACHE）Ⅱ以及存活率和病死率的差异。结果两种血液净化方式治疗后，两组患者血清肌酸激酶同工酶（CK．MB）、肌酸激酶（CK）、肌酐（cr）、谷草转氨酶（AST）、谷丙转氨酶（ALT）水平，1d、2d、和7d的APACHEⅡ评分均低于治疗前水平，差异具有统计学意义（P〈0．05）；SLED组与CBP组比较，患者的住院天数、生化指标、APACHEⅡ评分、血流动力学参数以及存活率和病死率差异均无统计学意义（P〉0．05）。结论SLED具有CBP相似的血流动力学稳定性，且两者在危重症患者中的治疗效果相当，SLED为临床治疗危重症提供了一种更经济方便的方式。Objective To compare the therapeutic effec between sustained low-efficiency dialysis （SLED） and continuous blood purification （CBP） in critically ill patients. Methods According to the treatment ways, 96 critically ill patients were divided into SLED group and CBP group. A comparison was made on the biochemical indicators, in-hospital duration, hemodynamic parameters, acute physiology and chronic health evaluation （ APACHE- II ）, the survival and the mortality rates. Results After treatment, the levels of serum creatine kinase isozyme MB （ CK-MB ） , creatine kinase （CK） , creatinine （Cr） , glutamic-oxalacetic transaminase （AST）, glutamate-pyruvate transaminase （ALT）, APACHE I1 score on the 1st, 2nd and 7th day were lower than those prior to the treatment in both groups （P 〈 0. 05 ）. There were no statistical differences in in-hospital duration, biochemical indicators, APACHE II score, hemodynamic parameters, the survival rate and the mortality rate between the two groups （ P 〉 0. 05 ）. Conclusions SLED has similar hemodynamic stability with CBP, and the two methods have similar treatment effects in critically ill patients. However, SLED can be relatively economical and convenient for critically ill patients in clinical.

关 键 词：持续低效血液透析 连续性血液净化 危重症 治疗效果 

分 类 号：R459.7[医药卫生—急诊医学]