CRRT治疗心脏术后急性肾损伤的疗效  

Efficacy of continuous renal replacement therapy in treating acute kidney injury after cardiac operation

作　　者：曾鸣 邢昌赢 俞香宝 任海滨 葛益飞 孙彬 

机构地区：[1]南京医科大学第一附属医院肾脏病科,江苏省210029

出　　处：《江苏医药》2014年第20期2398-2400,共3页Jiangsu Medical Journal

基　　金：国家十二五科技支撑计划项目(2011BAI10B08)

摘　　要：目的探讨连续性肾脏替代治疗(CRRT)对心脏术后急性肾损伤(AKI)患者的治疗效果。方法将心脏术后发生AKI且需行CRRT的17例患者分为存活组(A组)和死亡组(B组),记录围手术期、CRRT治疗前后的临床指标,分析肾功能和预后的关系。结果 17例AKI患者经CRRT治疗后死亡6例。与B组相比,A组术后距CRRT开始时间缩短(P<0.05),CRRT持续时间较长(P<0.01)。与治疗前相比,两组CRRT治疗后血清肌酐和尿素氮均下降(P<0.01和P<0.05),A组平均动脉压增加(P<0.01)。术前肾功能异常患者与正常患者的死亡比例无统计学差异(P>0.05)。结论 CRRT是心脏术后AKI的有效治疗手段,术后早期长时间CRRT能提高患者生存率。Objective To investigate the efficacy of continuous renal replacement therapy （CRRT） in the treatment of acute kidney injury（AKI） after cardiac surgery. Methods Seventeen patients received CRRT after cardiac surgery were divided into two groups of A（survival, 11 cases） and B（died,6 cases）. The perioperative variables and biochemical data before and after CRRT were recorded. The relationship between renal function and prognosis was analyzed. Results Six AKI patients were died after CRRT. Compared with group B, the time from postoperation to CRRT initiation was shortened （P〈0. 05 ）, while the duration of CRRT was prolonged in group A （P-0. 01）. Compared with before, serum levels of creatinine and blood urea nitrogen during CRRT after treatment were decreased in both groups（P〈0. 01 or P〈0. 05）, and mean arterial pressure was increased in group A （P〈0. 01 ）. There was no significant difference in the propotion of deaths between the patients with normal and abnormal baseline renal function （P〉0. 05）. Conclusion CRRT is an effective treatment for AKI after cardiac surgery. Early initiation and prolonged duration of CRRT may increase the survival rate.

关 键 词：急性肾损伤 连续性肾脏替代治疗 

分 类 号：R692[医药卫生—泌尿科学]