持续肾脏替代治疗时间对终末期肾衰竭伴急性心肌梗死患者预后和费用的影响  

The effect of continuous renal replacement therapeutic period on the prognosis and cost in end-stage renal disease and acute myocadial infarction patients

作　　者：陈丽[1] 姜蕾[1] 梁伟[1] 侯霜[1] 郑磊[1] 王青[1] 熊祖应[1] 

机构地区：[1]北京大学深圳医院肾内科,深圳518036

出　　处：《临床肾脏病杂志》2013年第5期222-224,共3页Journal Of Clinical Nephrology

摘　　要：目的探讨不同时间的连续性肾脏替代治疗（continuous renal replacement therapy,CRRT）对终末期。肾衰竭合并血流动力学不稳定的危重症患者预后和费用的影响。方法回顾性分析我院诊断为终末期肾衰竭合并急性心肌梗死，并存在血流动力学不稳定的患者23例，其中日间组（A组）17例，每日治疗时间为8～12h；24h组（B组）6例，每日治疗时间为20-24h。结果2组患者在日均脱水量、白蛋白（Alb）、血红蛋白（Hb）水平及低血压发生率、病死率、住院时间上无统计学差异（P〉0．05）。在出血事件发生率和治疗费用上A组均低于B组，2组比较有统计学差异（P〈0．05）。结论日间CRRT可能在救治此类危重患者中以较低的成本获得与治疗24h相同的效果，但并发症和病死率无明显增多。Objective To investigate the effect and cost of continuous renal replacement therapy （CRRT） for different therapeutic periods in the critical patients with end-stage renal disease and unsta- ble hemodynamics. Methods A retrospective study was performed to compare the clinical data of 23 cases diagnosed as end-stage renal disease with acute myocardial infarction and unstable hemodynam- ics. Seventeen cases （group A） received daytime CRRT for 8 - 12 h, and the rest 6 cases （group B） re- ceived 24- h CRRT for 20 - 24 h. Results The amount of dehydration, albulmin and hemoglobin levels, mortality and hospital stay showed no statistically significant difference between two groups （P〉0. 05）. The incidence of hemorrhage and the treatment costs showed significant difference （P〈0. 05）. Conclusions Daytime CRRT may have the same effect as 24 - h CRRT by lower cost in the treatment of critical patients with end-stage renal disease and unstable hemodynamics without increasing compli- cations and mortality.

关 键 词：肾脏替代疗法 预后 并发症 治疗费用 

分 类 号：R692.5[医药卫生—泌尿科学]