持续加强腹膜透析与持续血液滤过在治疗尿毒症合并脑出血中的对比分析

Analysis of intensified peritoneal dialysis and continuous hemofiltration in treatment for patients with uremia and cerebral hemorrhage

目的 对比无肝素持续血液滤过(HF)与加强腹膜透析(PD)在尿毒症合并脑出血患者中治疗作用。方法 回顾性将尿毒症合并脑出血的患者按治疗方式分为血液滤过组和加强腹膜透析组,比较二者对溶质及水分的清除,以及对凝血系统和生存率的影响。结果 二者对水分的清除无明显差异,HF组对肌酐的清除高于PD组(P<0.01)。HF组生存率明显低于PD组(P<0.05)。死亡患者的Glsagow-pittsburgh评分明显低于生存者(P<O.05)。结论 加强PD可提高尿毒症合并脑出血的生存率,是否为该类患者的首选治疗方式尚待循证医学研究。

Objective TO investigate the theiapeutic efliect of continuous vein - vein hemofiltration without heparin and intensified peritoneal dialysis on patients with uremia and cerebral hemorrhage. Methods 21 uremia patients with cerebral hemorrhage were retrospectively analysed. We compared the clearance of low molecular weight toxin and water, and the influence of two methods on the coagulation system and survival. Resute The two methods can clear sufficienth/ overload water equally. There are no difiference in APTT and PT of the patients with two methods. The serum creatinine decreased more significanth/ in patients with hemofiltration than those with peritoneal dialysis (P < 0.01) .The survival of patients with hemofiltration was lower than those with peritoneal dialysis ( P < 0.05) . The survival has a higher Qsagow -pittsburgh score( P < 0.05). Conduskm The intensified peritoneal dialvsis can unprove the survival of patients with uremia and cerebral hemorrhage . A controlled trial will be required to confinn whether the intensified peritoneal dialysis will be the first choice for this kind of patients