连续性血液净化治疗心肾功能衰竭及多脏器功能衰竭22例临床分析  

Continuous blood purification treatment of heart of 22 cases of renal failure and multiple organ function failure clinical analysis

作　　者：邵长青 

机构地区：[1]河南神火集团职工总医院ICU科,河南永城476600

出　　处：《医药论坛杂志》2018年第1期73-75,共3页Journal of Medical Forum

摘　　要：目的为比较连续性血液净化联合药物治疗心肾功能不全及多脏器功能衰竭和药物治疗的效果。方法选择河南神火集团职工总医院自2016年1月—2017年6月收治的心肾功能不全及多脏器功能衰竭患者46例,其中男35例,女11例,年龄32~86岁。分为对照组和治疗组,对照组24例,治疗组22例。对照组依据患者基础疾病、心肾功能不全分级及多脏器功能衰竭等病情,给予控制血压、强心利尿、扩张血管、减轻心脏前后负荷、营养心肌、控制血糖,保护肝肾功能、保护胃粘膜等处理措施,及控制感染,维持内环境稳定及其他对症支持治疗。治疗组在上述治疗措施的基础上,加用连续性血液净化治疗。两组患者并发呼吸衰竭者予呼吸机辅助呼吸,脑水肿者予脱水降颅压等治疗。结果治疗组22例,其中14例心、肾、肝功能改善,5例心肾肝功能转为正常,1例3个月后发展为多脏器功能衰竭死亡,2例合并脑干出血放弃治疗死亡。对照组24例,其中10例心肾功能改善,14例先后因肺部感染加重、呼吸衰竭及多脏器功能衰竭死亡。经统计学处理,P<0.05,差异有统计学意义。结论持续性血液净化联合药物治疗心肾功能衰竭及多脏器功能衰竭疗效明显优于药物治疗,值得临床推广应用。Objective To compare the continuous blood purification combined heart drug treatment of renal dysfunction and multiple organ function failure and the effect of drug treatment. Methods Choose since 2016. Jan-2017. June 46 patients,set in the control group and treatment group and control group 24 cases,22 cases in treatment group,aged from 32 to 86 years old,35 cases of men and women 11 cases. Heart renal dysfunction and multiple organ failure patients were divided into 2 groups,the treatment group and control group,patients in the control group on the basis of basic diseases,heart kidney is not complete grading and multiple organ function failure condition,such as giving control blood pressure,strong heart diuresis,dilate blood vessels,reducing heart load,myocardial nutrition,control blood sugar,protect the liver and kidney function,processing measures,such as protection of gastric mucosa and control infection,maintain a stable internal environment,and other support therapy. The treatment group was treated with continuous blood purification based on the above treatment measures. Two groups of patients with respiratory failure were treated with respiratory aid,and cerebral edema was treated with dehydration and subcranial pressure. Results Treatment group（ 22 cases,including 14 cases of heart,kidney,liver function improved,5 cases of liver function to normal heart kidney,1 case of developing multiple viscera function failure,2 case of merger brainstem hemorrhage giving up treatment and death. In the control group,there were 24 cases in the control group,10 of which were improved in cardiac function,and 14 were fatal in pulmonary infection,respiratory failure and multiple organ failure. Statistically processing,P〈 0. 05 was statistically significant. Conclusion The efficacy of continuous blood purification combined with drug therapy for heart failure and multi-organ failure is better than that of drug therapy,and it is worthy of clinical application.

关 键 词：连续性血液净化 心肾功能衰竭 多脏器功能衰竭 

分 类 号：R692.5[医药卫生—泌尿科学]