连续性静脉-静脉血液滤过对难治性心力衰竭的疗效  

Clinical outcomes of continuous veno-venous hemofiltration in treating patients with refractory heart failure

作　　者：罗香香[1] 刘少精 林森[1] 黄永善[1] 麦燕婷[1] 

机构地区：[1]海南省农垦三亚医院ICU,572000

出　　处：《江苏医药》2014年第18期2120-2122,共3页Jiangsu Medical Journal

摘　　要：目的探讨连续性静脉-静脉血液滤过(CVVH)对难治性心力衰竭(RHF)的疗效。方法 112例RHF患者随机均分为两组:对照组予常规治疗,试验组在常规治疗基础上同时进行CVVH治疗。比较两组治疗前后RR、HR、MAP、血氧饱和度(SaO2)、24-h尿量、左心射血分数(EF)、CVP、心胸比和血浆TNF-α、IL-6、超敏C反应蛋白(hsCRP)和胱抑素C(Cys-C)的变化。结果两组治疗后,HR、RR、CVP、心胸比、TNF-α、IL-6、hsCRP和Cys-C均较治疗前降低(P<0.05),SaO2、24-h尿量和EF均较治疗前升高(P<0.05);试验组较对照组变化更为明显(P<0.05)。与对照组相比,试验组住院时间缩短,再发间期延长(P<0.05)。结论 CVVH能有效地清除RHF患者体内过多的水、钠和炎症介质,更好地恢复心脏功能。Objective To study the clinical outcomes of continuous veno-venous hemofiltration （CVVH） in treating the patients with refractory heart failure（RHF）. Methods A total of 112 RHF patients was equally and randomly divided into groups of B（treated with conventional therapy） and A （treated with additional CVVH）. The changes of respiratory rate（RR）, heart rate（HR）,mean arterial pressure （MAP）, oxygen saturation （SaO2）, 24-hour urine volume, ejection fraction （EF）, central venous pressure （CVP）, cardiothoracic ratio, plasma TNF-α, IL-6, high sensitive C-reactive protein （hsCRP） and cystatin C（Cys-C） before and after treatment were compared between two groups. Results The levels of HR, RR, CVP, cardiothoracic ratio, TNF-a, IL-6, hsCRP and Cys-C were all lower,SaO2,24-hour urine volume and EF were higher, after treatment than those before in two groups（P〈0.05） ,which were changed more obviously in group A than those in group B（P〈0. 05）. Compared with group B, the hospital stay was shorter and the recurrence intervals were longer in group A（P〈0. 05）. Conclusion CVVH can effectively eliminate excess body water, sodium and inflalmnatory mediators and better restore the cardiac function in patients with RHF.

关 键 词：连续性静脉-静脉血液滤过 难治性心力衰竭 

分 类 号：R541[医药卫生—心血管疾病]