每日序贯透析在尿毒症并心力衰竭诱导透析期的应用分析  

Clinical analysis of daily sequential dialysis on induction phase of hemodialysis in patients with uremia accompanied by heart failure

作　　者：麦林发 梁琴 陈夏 黄星 汤伟光 Mai Linfa Liang Qin Chen Xia et al(The People＇s Hospital of Hezhou City,Hezhou, Guangxi 54289)

机构地区：[1]贺州市人民医院,广西贺州542899

出　　处：《基层医学论坛》2016年第30期4189-4191,共3页The Medical Forum

摘　　要：目的观察每日序贯透析在尿毒症并心力衰竭诱导透析期的临床疗效及可行性。方法将新进入血液透析治疗尿毒症患者分为每日序贯透析组及CRRT组各31例,分别检测透析前第1天、透析第7天的BUN、SCr、BNP、LVEF及HR;比较2组心功能改善效果、失衡综合征发生率、住院日数及总费用。结果治疗后2组血BUN、SCr、BNP均较治疗前显著减低,LVEF及HR均显著改善(P<0.01),但组间差异无统计学意义;心功能疗效均为100%;失衡综合征发生率及住院日数组间比较差异无统计学意义(P>0.05);但CRRT组住院费用大幅增加(P<0.01)。结论每日序贯透析在尿毒症并心力衰竭诱导透析期中能提供一种有效、安全、舒适、平稳、经济的血液净化过程,有利于基层医院推广应用。Objective To investigate the effect and feasibility of daily sequential dialysis on induction phase of hemodialysis in patients with uremia accompanied by heart failure,as well as search for a safe,effective and economic treatment thought. Methods A retrospective study on 62 new hemodialysis patients with uremia accompanied by heart failure during 2012 to 2015 from people＇s hospital of Hezhou. Patients were distributed randomly into two groups,each with 31,then treated with daily sequential dialysis and continuous renal replacement therapy（CRRT）,respectively. In the first day prior to treatment and the 7th day after treatment,detected the blood urea nitrogen（BUN）,serum creatinine（SCr）,brain natriuretic peptide（BNP）,Left ventricular ejection fraction（LVEF）and change of heart rate（HR）and compared the improvement efficacy of cardiac function,rate of disepuilibrium,hospitalization time and total treatment cost between two group. Results After treatment,the content of BUN,SCr and BNP were both lower significantly（P〈0.01）compared to prior treatment,couple with improvement in LVEF grading and heart rate（HR）in both group,yet there was no statistical significant between intergroup,so as to heart function. Moreover,the incidence rate of two groups of disequilibrium syndrome is no statistically significant difference. Last but not the least important,hospitalization time of patients in two group were almost the same,while the CRRT need more total treatment cost（P〈0.01）.Conclusion Daily Sequential dialysis may be a blood purification process on induction phase of hemodialysis in patients with uremia accompanied by heart failure,which is safe,effective,comfortable,stay and economic,and be suitable for primary hospital whose medical equipments were backward.

关 键 词：尿毒症 心力衰竭 诱导透析期 序贯透析 应用效果 

分 类 号：R692.5[医药卫生—泌尿科学]