连续性肾脏替代治疗与间歇性血液透析治疗多器官衰竭的疗效比较

Comparison of Efficacy between Continuous Renal Replacement Therapy and Intermittent Hemodialysis on Acute Renal Failure Associated with Multiple Organs Failure

目的：比较连续性肾脏替代治疗(CRRT)与间歇性血液透析(IHD)对伴急性肾功能衰竭的多器官衰竭的治疗效果。方法：CRRT组22例,IHD组26例,监测治疗前后血电解质、BUN、SCr,记录治疗中低血压发生次数、出血次数。结果：治疗中CRRT组低血压发生次数少于IHD组(P＜0．05),治疗后BUN、SCr均低于IHD组(P＜0．05),但出血次数多于IHD组(P＜0．05)。两组虽死亡率相近,但CRRT组治疗前APACHEⅡ评分高于IHD组,CRRT组肾功能恢复时间短于IHD组(P＜0．05)。结论：CRRT血液动力学稳定、溶质清除率高,能改善多器官衰竭患者的预后。

Objective：To compare the efflicacy of continuous renal replacement therapy （CRRT）and intermittent hemodialysis （IHD）on acute renal failure（ARF） associated with multiple organs failure（MOF）. Methods：Of 48 ARF cases with MOF, 22 received CRRT and 26 underwent IHD. Blood electrolytes, blood urea nitrogen（BUN）, serum creatinine（Scr） were detected in all patients before and after hemopurification. The frequency of hypotention and bleeding were recorded during hemopurification. Results： The frequency of hypotention in CRRT group were much lower than IHD group（P〈0. 05）. BUN,Scr in CRRT group were also much lower than IHD group after hemopurification（P〈0. 05）. But the frequency of bleeding in CRRT group were higher than IHD group（P〈0.05）. Renal function recovery time was shorter in CRRT group than in IHD group. APACHE-Ⅱ scores of CRRT group were higher than IHD group before hemopurification, although the death rate has no significant difference. Conclusion：CRRT may be of choice for the treatment of ARF associated with MOF. It can offer more stable dynamic and better prognosis.