连续性静脉－静脉血液滤过治疗妊娠合并急性肾衰竭临床分析

Continuous venovenous hemofiltration in acute renal failure complicating pregnancy

目的观察连续性静脉－静脉血液滤过（CVVH）治疗妊娠合并急性肾衰竭的临床疗效。方法回顾性分析26例妊娠合并急性肾衰竭患者采用CVVH治疗的资料，每例患者治疗30～89h，平均48h，滤过器采用AN69，AV600S，血流量100～150ml／min，置换液流量1500－2500ml／h，采用前稀释法。结果26例患者中，23例存活，3例转为慢性肾衰竭，治疗后血尿素氮、肌酐、尿酸明显下降，死亡3例。人工流产术4例，22例均适时终止妊娠，16例剖宫产，6例阴道分娩；胎儿存活18例。结论CVVH治疗妊娠合并急性肾衰竭安全、有效，值得推广。

Objective To evaluate the effect of continous venovenous hemofiltration（CVVH） in treatment of the pregnancy complicated with acute renal failure （ARF）. Method 26 patients with pregnancy complicated with ARF received continous venovenous hemofiltration for 30 to 89 hours. The average time of CVVH was 48 hours. AN69,AV 600S, hemofilters were used. Infusion rate of replacement fluid was 1 500-2 500ml/h, blood flow rate was 100-150ml/min, and the substitute fluid was infused by a pre-dilution route. Results Three patients died during the course of treatment. The mortality was 11.6%. The other 23 patients survived, with three patients remained on chronic hemodialysis. Urea nitrogen, creatinine and uric acid were reduced obviously. Conclusions CVVH is a safe and effective way in treating pregnancy patients complicated with ARF.