连续性血液透析治疗老年终末期心功能不全103例临床研究  

Clinical research of continuous renal replacement therapy on the old year-end final cardiac dysfunction

作　　者：方志成[1] 郑翔[1] 盛春风[1] 黄云飞[1] 

机构地区：[1]湖北医药学院附属太和医院重症医学科,十堰442000

出　　处：《陕西医学杂志》2014年第3期288-290,共3页Shaanxi Medical Journal

摘　　要：目的:观察连续性肾脏替代治疗(CRRT)对老年终末期心功能不全患者的疗效。方法:201例老年终末期心功能不全患者分血液透析组和对照组,脉搏指示连续心输出量监测(PiCCO)心输出量(CO)、心指数(CI)、血管外肺水(EVLWI)、心率(HR)评估血流动力学,测定血浆脑型利钠肽(BNP)评估心功能,记录机械通气参数及呼吸机支持力度,测定动脉血气,评估肺功能情况。结果:与对照组相比,血液透析组血流动力学CO(3.47±0.14vs 4.59±0.37)、CI(3.45±0.24vs 4.68±0.75)、EVLWI(7.89±0.74vs 5.67±0.21),BNP(13283.98±173.91vs 4584.26±94.71),呼吸机支持力度明显下降,动脉血气氧分压(85.32±14.35vs 101.43±5.87)提高,肺泡-动脉氧分压差(15.38±3.61vs 7.53±3.54)下降,心肺功能改善。结论:缓慢、连续性血液透析可有效治疗老年终末期心功能不全,与缓慢脱水减轻心脏负担、改善肺功能等有关。Objective：To observe CRRT insuffi ciency of the old year-end-stage cardiac function of pa-tients .Methods ：201 cases of the old year-end final heart function insufficiency were divided into CRRT group and the control group ,PiCCO monitored CO ,CI ,EVLWI ,HR to evaluate the hemodynamic evaluation of cardiac func-tion determination of plasma BNP ,records of mechanical ventilation parameters and ventilator support ,and arterial blood gas was measured to assess lung function situation .Results ：Compared with the control group ,CRRT group blood flow dynamics CO （3 .47 ± 0 .14 vs 4 .59 ± 0 .37） ,CI （3 .45 ± 0 .24 vs 4 .68 ± 0 .75） ,EVLWI （7 .89 ± 0 .74 vs 5 .67 ± 0 .21） ,BNP （13283 .98 ± 173 .91 vs 4584 .26 ± 94 .71） ,ventilator support decreased arterial blood gas partial pressure of oxygen （85 .32 ± 14 .35 vs 101 .43 ± 5 .87）improved alveolar-arterial oxygen difference （15 .38 ± 3 .61 vs 7 .53 ± 3 .54） decreased ,heart and lung function improved .Conclusion：continuity hemodialysis can be effective in treating the old year-end final heart function insufficiency ,and slowly dehydrated to alleviate the burden on the heart ,and improve lung function .

关 键 词：心力衰竭 治疗 血液透析滤过 方法 老年人 

分 类 号：R541[医药卫生—心血管疾病]