CVVH早期抢救阿昔洛韦过量致急性肾损伤的体会  

Experience of Early Rescue of Acute Kidney Injury Caused by Acyclovir Overdose in CVVH

作　　者：姜晓岚[1] 刘斌[1] 杨玲[1] 白帆[1] 

机构地区：[1]昆明市第一人民医院肾内科,云南昆明650011

出　　处：《中外医疗》2017年第32期43-44,47,共3页China & Foreign Medical Treatment

摘　　要：目的比较CVVH(连续性床旁静脉—静脉血液滤过)与HD(血液透析)在抢救阿昔洛韦(acyclovir)过量致早期急性肾损伤(acute kidney injury)患者的疗效。方法方便选取2010年1月—2016年6月该院确诊接收的32例阿昔洛韦过量致早期急性肾损伤患者为研究对象,将其随机分为CVVH治疗组和HD治疗组,每组16例。CVVH治疗组每日予CVVH治疗≥8 h,置换量≥3 L/h,血流量200~250 m L/min,滤器为AV600 s。HD治疗组每日予HD治疗3~4 h,血流量200~250 m L/min,透析器均为高通量透析器。观察两组患者每日尿量变化、进入恢复期患者数及BUN、Cr下降情况及不良反应(包括有血压变化,HB下降,凝血功能变化)的比较。结果尿量3 d内CVVH组尿量平均(535.60±155.30)m L,进入恢复期的患者百分比为62.5%,尿量7 d内CVVH组尿量平均为(871.03±160.27)m L,进入恢复期的患者百分比为75.0%,均明显高于HD治疗组,两组对比差异有统计学意义(P<0.05)。结论 CVVH治疗和高通量的血液透析治疗在抢救阿昔洛韦过量致早期急性肾损伤患者均有较好疗效,为药物过量致早期急性肾损伤提供了新的治疗手段。Objective This paper tries to compare the efficacy of CVVH（continuous bedside veno venous hemofiltration）and HD（hemodialysis） in the treatment of acute kidney injury caused by overdose acyclovir. Methods From January 2010 to June 2016, 32 patients with acute renal injury induced by excessive acyclovir in this hospital were convenient enrolled in this study and were randomly divided into the CVVH treatment group and the HD treatment group, with 16 cases in each group. CVVH treatment group received CVVH treatment for more than 8 h a day; the displacement was larger than 3 L/h,the blood flow of 200~250 m L/min, filter for AV600 s. The HD treatment group was treated with HD for 3~4 h every day,the blood flow was 200~250 m L/min, and the dialyzer was high throughput dialyzer. The daily urine volume, the number of patients in recovery stage, the decline of BUN and Cr and adverse reactions（including changes of blood pressure, HB and coagulation function in two groups） were observed. Results The average urine volume within 3 d of the CVVH group was（535.60 ±155.30）m L, the percentage of patients in the recovery period was 62.5%, the amount of urine within 7 d of the CVVH group was（871.03±160.27）m L, the percentage of patients in the recovery period was 75.0%, significantly higher than that of HD group, there were differences between the two groups, with statistical significance（P〈0.05）. Conclusion CVVH treatment and high throughput hemodialysis treatment are effective in the treatment of early acute renal injury in patients with excessive acyclovir, which provides a new treatment for early acute kidney injury caused by excessive drug use.

关 键 词：CVVH:连续性床旁静脉—静脉血液滤过 阿昔洛韦 急性肾损伤 

分 类 号：R64[医药卫生—外科学]