连续静脉-静脉血液滤过治疗糖尿病肾病并发难治性充血性心力衰竭

Treatment of diabetic nephropathy complicate refractory congestive heart failure by CVVH

目的观察连续静脉-静脉血液滤过(Continuous Venovenous hemofiltration,CVVH)治疗糖尿病肾病(Di-abetic neuropathy,DN)并发难治性充血性心力衰竭(CHF)疗效以及安全性。方法行股静脉或颈内静脉插管术,置入双腔导管,建立临时性血管通路,选用YT-120SPAN血滤器进行床旁CVVH。结果45例DN并发CHF患者治疗后,全身浮肿明显消退,肺部湿罗音消失,呼吸困难明显缓解。在血流速率150-180ml/min、超滤量平均达12.56L时,患者均未出现低血压等并发症,平均动脉压波动幅度(113±3.9)mmHg,心率波动幅度(13±3.8)次/分。结论CVVH可以安全地用于治疗糖尿病肾病并发CHF以及高度水肿、电解质及酸碱平衡失调。

Objective To watch continuous venovenous hemofiltration （CVVH） and reach the curative effect and safety of the treatment of diabetic neuropathy complicate refractory congestive heart failure （CHF）. Methods To carry on beside continuous venovenous hemofiltrafion using YT- 120SPAN blood filter by taking femorao vein encheiresis, inserting double channel catheters and setting up critical blccod vessel passages. Results After this treawnent, 45 cases of the patients of CHF has been improved , their anasarca disappeared, When the blood flow rate is at 150 - 180ml/min, and the average udrafiltrafion rate at 12.156L, these is no appearance of hypotension or complication, with the result of the average arterial pressure fluctuation （ 113 ± 3.9）mmHg and heart rate （ 13± 3.8）/min. Conclusion CVVH can be safely used for treawnent of the congestive failure and its complications such as high edema, the electrolyte disturbance and acid - base imbalance.