连续性肾脏替代治疗在心脏直视手术后合并急性肾功能衰竭患者中的应用  

Application of continuous renal replacement therapy on patients with acute renal failure after open heart surgery

作　　者：张满堂[1] 吴小永[1] 杜敏 王茜 Zhang Mantang;Wu Xiaoyong;Du Min;Wang Qian(Department of Cardio-Thoracic Surgery,Jiaozuo People’s Hospital,Jiaozuo 454000,China;Department of Critical Medicine,Jiaozuo People’s Hospital,Jiaozuo 454000,China)

机构地区：[1]焦作市人民医院心胸外科,焦作454000 [2]焦作市人民医院重症医学科,焦作454000

出　　处：《中国实用医刊》2023年第5期57-60,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨连续性肾脏替代治疗(CRRT)在心脏直视手术后合并急性肾功能衰竭(ARF)患者中的应用效果。方法抽取2018年2月至2022年2月焦作市人民医院收治的心脏直视手术后合并ARF患者60例,根据治疗方案分为对照组与观察组,每组30例。对照组予以腹膜透析治疗,观察组采用CRRT治疗。比较两组治疗前后血清炎性因子水平[白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)]与血生化指标(血清钾离子、血肌酐、尿素氮水平),比较两组治疗后半年内的病死率与并发症发生率,比较两组存活患者的尿量恢复正常时间与肾功能恢复正常时间。结果治疗前,两组血清炎性因子水平、血生化指标比较差异未见统计学意义(P>0.05);治疗后,观察组IL-1β、IL-6、TNF-α水平低于对照组,血清钾离子、血肌酐、尿素氮水平亦低于对照组(P<0.05)。观察组病死率(10.00%,3/30)及并发症发生率(26.67%,8/30)均低于对照组(33.33%,10/30;63.33%,19/30),P<0.05。随访调查两组存活患者结果显示,观察组尿量恢复正常时间[(7.04±2.10)d]与肾功能恢复正常时间[(12.11±2.19)d]均少于对照组[(9.15±2.92)、(14.20±3.69)d],差异有统计学意义(P<0.05)。结论采取CRRT治疗心脏直视手术后合并ARF患者,可更好地改善其血清炎性因子水平及血生化指标,同时可减少死亡与并发症发生,缩短尿量与肾功能恢复时间。Objective To investigate the effect of continuous renal replacement therapy(CRRT)on patients with acute renal failure(ARF)after open heart surgery.Methods A total of 60 patients with ARF after open heart surgery admitted to Jiaozuo People’s Hospital from February 2018 to February 2022 were selected,and they were divided into control group and observation group according to treatment schemes,with 30 cases in each group.The control group was treated by peritoneal dialysis(PD),and the observation group was treated by CRRT.The levels of serum inflammatory factors including interleukin-1β(IL-1β),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α),and blood biochemical indexes including serum potassium ion,creatinine and urea nitrogen were compared between the two groups before and after treatment.The case fatality rate and complication rates of the two groups within 6 months after treatment were compared.The time of urine volume recovery and renal function recovery were compared between the two groups.Results Before treatment,there was no significant difference in the levels of serum inflammatory factors and blood biochemical indexes between the two groups(P>0.05).After treatment,the levels of IL-1β,IL-6 and TNF-αin the observation group were lower than those in the control group,the levels of serum potassium ion,serum creatinine and urea nitrogen were also lower than those of the control group(P<0.05).The case fatality rate(10.00%,3/30)and complication rate(26.67%,8/30)in the observation group were lower than those in the control group(33.33%,10/30;63.33%,19/30),P<0.05.Results of follow-up survey of two groups showed that the time for urine volume to return to normal and renal function to return to normal in the observation group were(7.04±2.10)d and(12.11±2.19)d,respectively,shorter than the(9.15±2.92)d and(14.20±3.69)d in the control group,and the difference was statistically significant(P<0.05).Conclusions Using CRRT in the treatment of patients with ARF after open heart surgery can better improve th

关 键 词：急性肾功能衰竭 心脏直视手术 连续性肾脏替代治疗 腹膜透析 血生化指标 

分 类 号：R692.5[医药卫生—泌尿科学]