CVVHDF与CVVH在ICU横纹肌溶解综合征应用疗效比较研究  

Comparative Study on the Curative Effect of CVVHDF and CVVH in the Application of Rhabdomyolysis in ICU

作　　者：周劲松 ZHOU Jinsong(Yangxin County People’s Hospital,Yangxin 435200,China)

机构地区：[1]阳新县人民医院,湖北阳新435200

出　　处：《中外医学研究》2021年第23期56-60,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:观察连续性静脉-静脉血液透析滤过(CVVHDF)与持续静脉-静脉血液滤过(CVVH)治疗横纹肌溶解综合征(RM)的效果,指导未来ICU RM患者的血液滤过治疗选择。方法:将笔者所在医院2016年1月-2019年12月ICU收治的168例RM患者作为研究对象,在告知患者及其家属CVVHDF与CVVH两种治疗方案后,结合患者个体情况,并遵循其意愿将其分为CVVH组(73例)与CVVHDF组(95例)。CVVH组采用CVVH方案治疗,CVVHDF组采用CVVHDF方案治疗。比较两组临床症状改善情况(包括肌肉酸痛消失时间、肌无力缓解时间与浓茶色尿消失时间)。分别于治疗前,治疗3、5、7 d,检测两组生化指标[血清肌酸磷酸激酶(CK)、肌红蛋白(Mb)、乳酸脱氢酶(LDH)、尿肌酐(Cr)、血尿素氮(BUN)]及尿量。结果:CVVHDF组肌肉酸痛消失时间、肌无力缓解时间及浓茶色尿消失时间均早于CVVH组,差异有统计学意义(P<0.05);治疗前后,两组CK、Mb、LDH、Cr、BUN、尿量的主效应差异有统计学意义(P<0.01);不考虑测量时间,两组间CK、Mb、LDH、Cr、BUN、尿量主效应差异有统计学意义(P<0.01);两组CK、Mb、LDH、Cr、BUN、尿量的时间点与组间存在交互作用(P<0.01),随着治疗时间的延长,两组CK、Mb、LDH、Cr、BUN均较治疗前降低,尿量均较治疗前升高,且CVVHDF组各时点CK、Mb、LDH、Cr、BUN水平均低于CVVH组,尿量均高于CVVH组,差异有统计学意义(P<0.05)。结论:ICU RM患者采用CVVHDF方案治疗,较CVVH方案更利于促进患者肾功能恢复,患者各主要症状得到更好更快缓解,可在ICU RM患者中推广开展。Objective:To observe the efficacy of continuous veno-venous hemodiafiltration(CVVHDF)and continuous veno-venous hemofiltration(CVVH)in the treatment of rhabdomyolysis(RM),and to guide the choice of hemofiltration treatment options for RM patients in ICU in the future.Method:A total of 168 patients with RM admitted in ICU of our hospital from January 2016 to December 2019 were selected as the study subjects.After the patients and their families were informed of the two treatment regimen of CVVHDF and CVVH,combined with the individual situation of the patients and following their wishes,they were divided into the CVVH group(73 cases)and the CVVHDF group(95 cases).The CVVH group was treated with CVVH regimen,and the CVVHDF group was treated with CVVHDF regimen.The improvement of clinical symptoms(including the disappearance time of muscle soreness,relief time of muscle weakness and the disappearance time of dark brown urine)was compared between the two groups.The biochemical indicators[serum creatine phosphokinase(CK),myoglobin(Mb),lactate dehydrogenase(LDH),urine creatinine(Cr),blood urea nitrogen(BUN)]and urine volume of the two groups were measured before treatment and 3,5,7 days after treatment.Result:The disappearance time of muscle soreness,relief time of muscle weakness and disappearance time of dark brown urine in the CVVHDF group were earlier than those in the CVVH group,and the differences were statistically significant(P<0.05).Before and after treatment,there were significant differences in the main effects of CK,MB,LDH,Cr,BUN and urine volume in the two groups(P<0.01).Regardless of the measurement time,there were statistical significant differences in the main effects of CK,Mb,LDH,Cr,BUN and urine volume between the two groups(P<0.01).There was interaction between the two groups in the time points of CK,Mb,LDH,Cr,BUN and urine volume(P<0.01),with the extension of treatment time,CK,Mb,LDH,Cr and BUN in both groups were decreased compared with those before treatment,and the urine volume was increased compa

关 键 词：连续性静脉-静脉血液透析滤过 持续静脉-静脉血液滤过 横纹肌溶解综合征 肾功能 

分 类 号：R685.5[医药卫生—骨科学]