连续性静脉—静脉血液透析滤过技术在慢性心力衰竭合并肾功能衰竭患者中的应用  

Continuous hemodiafiltration in chronic heart failure and renal failure patients application effect analysis

作　　者：回志[1] 李哲[2] 苗晓云[1] HUI Zhi LI Zhe MIAO Xiaoyun(Department of Intensive Critical Care, Cangzhou Central Hospital , Changzhou 061000, China)

机构地区：[1]河北省沧州市中心医院重症医学科,061000 [2]河北省沧州市中心医院心内一科,061000

出　　处：《疑难病杂志》2016年第10期1002-1005,共4页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的研究连续性静脉—静脉血液透析滤过技术在慢性心力衰竭合并肾功能衰竭患者中的应用效果。方法选取2014年1月—2015年12月河北省沧州市中心医院重症医学科收诊慢性心力衰竭合并肾功能衰竭患者80例,按照随机数字表法分为观察组与对照组,每组40例。对照组采用常规透析治疗,观察组采用连续性静脉—静脉血液透析滤过技术治疗,比较2组患者治疗前后呼吸频率(BR)、心率(HR)、平均动脉压(MAP)、急性生理与慢性健康评分(APACHEⅡ评分)、Boston心力衰竭评分、血气分析(pH、HCO_3^-、PaO_2、SaO_2)、肾功能(SCr、UBN)以及心功能指标(SV、CO、LVEF)等方面的变化。结果观察组总效率为95.0%,显著高于对照组的85.0%(x^2=12.31,P<0.05);2组患者治疗前BR、HR、MAP、APACHEⅡ评分、Boston心力衰竭评分差异均无统计学意义(P>0.05),2组治疗后BR、HR、MAP、APACHEⅡ评分、Boston心力衰竭评分与治疗前比较,差异均有统计学意义(P<0.05),且观察组均优于对照组(P<0.05);2组患者治疗后血气分析以及肾功能指标均显著改善,差异有统计学意义(P<0.05),且观察组均优于对照组(P<0.05);2组患者治疗后SV、CO、LVEF均显著改善,差异有统计学意义(P<0.05),且观察组均优于对照组(P<0.05)。结论连续性静脉—静脉血液透析滤过技术在治疗慢性心力衰竭合并肾功能衰竭中具有较好的应用价值,能够显著改善患者的临床症状以及预后情况,提高患者的生活质量。Objective To investigate the continuous hemodiafiltration in chronic heart failure and renal failure pa-tients application results provide the basis for clinical.Methods From January 2014 to December 2015, 160 cases diagnosed with chronic heart failure and renal failure were enrolled, according to the number table, they were randomly divided into ob-servation group and control group, 80 cases in each group.The control group received routine dialysis treatment, observation group received continuous hemodiafiltration treatment, before and after treatment, respiratory rate （ BR） , heart rate （ HR） , mean arterial pressure （ MAP） , acute physiology and chronic health evaluation （ APACHEⅡscore） , changes in heart fail-ure rates Boston, blood gas analysis （ pH, HCO3 , PaO2 , SaO2 ） , blood biochemistry （ serum creatinine, blood urea nitrogen） and cardiac function parameters （ SV, CO, LVEF） and other aspects were compared.Results The total efficiency of observa-tion group was 95.0%, which was significantly higher than the 85.0%of control group （χ2 =12.31, P 〈0.05）;2 groups of patients before treatment, BR, HR, MAP, APACHEⅡscore, Boston heart failure score were statistically significant different from after treatment （ P 〉0.05）, 2 groups after treatment, BR, HR, MAP, APACHE ⅱ score, Boston heart failure score compared with before treatment, the difference was statistically significant （ P 〈0.05） , and the observation group in HR, A-PACHE ⅱscore, Boston heart failure scores better than the control group （ P 〈0.05）;blood gas analysis and renal function differences between the two groups of patients before and after treatment were statistically significant （ P 〈0.05） , and the ob-servation group＇s HCO3 , SaO2 , SCr, UBN and other indicators were improved than the control group （ P 〈0.05）;2 groups of patients before and after treatment＇s SV, CO, LVEF＇s differences were statistically significant （ P 〈0.05） , and the obser-vation group＇s SV,

关 键 词：连续性静脉—静脉血液透析滤过技术 心力衰竭 慢性 肾功能衰竭 心功能 

分 类 号：R541.6[医药卫生—心血管疾病] R692.5[医药卫生—内科学]