连续性肾脏替代治疗在难治性心肾综合征中的临床观察  

Continuous renal replacement therapy in refractory cardiorenal syndrome in clinical observation

作　　者：于泽莺 刘加明[1] 李旭[1] 金鑫[1] 王春莲[1] 

机构地区：[1]新疆石河子市人民医院肾病内科,石河子832000

出　　处：《新疆医学》2017年第7期735-737,共3页Xinjiang Medical Journal

摘　　要：目的观察连续性肾脏替代治疗(continuous renal replacement therapy,CRRT)对难治性心肾综合征(cardiorenal syndrome,CRS)的疗效。方法选取新疆石河子市人民医院2013年3月-2015年12月收治40例难治性心肾综合征患者为研究对象。分为CRRT组与对照组各20例,观察治疗前后患者血尿素氮(BUN)、血肌酐(Scr)、动脉血PH值、实际碳酸氢盐浓度(AB)、尿量、左心室射血分数(LVEF)、氨基末端B型脑钠肽前体(BNP)指标的变化,以及发生严重并发症及住院期间病死率改变。结果治疗48 h后CRRT组BUN、Scr、BNP较治疗前下降(P<0.05),对照组BUN、Scr较治疗前升高(P<0.05),BNP较治疗前下降(P<0.05),两组均有不同程度的尿量增多、LVEF数值升高、动脉血PH值、AB升高,CRRT组有2例低血压,未出现出血、栓塞、感染等不良反应,均好转出院。对照组有4例死亡。结论 CRRT治疗难治性心肾综合征是安全、有效,能改善临床症状,延长生命,提高患者生活质量。Objective To investigate curative effect of Continuous renal replacement therapy （CRRT） on refractory cardiorenal syndrome （CRS）. Methods 40 patients with refractory cardiorenal syndrome admitted people＇s hospital of shihezi city from Mareh 2013 to December 2015 were Selected as the research object. All eases were divided into CRRT group and control group （n = 20）, these following indexes were observed before and after treatment including blood urea nilrogen （BUN）, serum ereatinine （Ser）, arterial blood pH value, the actual concentration of bicarbonate （AB）, urine volume, left ventricular ejection fraction （LVEF） and amino terminal b-type brain natriuretic peptide precursor （BNP）, and the serious complications and changes of death rate were observed too. Results BUN, Scr and BNP was decreased in CRRT group 48 hours after treatment （P〈0.05）, BUN, Scr of the control group were higher than those before treatment （P〈0.05）, BNP in both groups decreased compared with that before the treatment （P〈0.05）. After treatment, Urine in two groups increased at different degrees, LVEF, arterial blood pH and AB increase too, 2 cases in CRRT group got low blood pressure. No adverse reactions such as bleeding, embolism, infection were observed in both groups, most of patients were relieved, there were 4 cases being dead in the control group. Conclusion CRRT treatment to refractory cardiorenal syndrome is safe, effective and can improve clinical symptoms, prolong life, improve the patients quality of llfe.

关 键 词：连续性肾脏替代治疗 心肾综合征 

分 类 号：R692.5[医药卫生—泌尿科学]