连续性肾脏替代治疗在心内直视术后急性肾功能衰竭的应用

Application of continuous renal replacement therapy to patients with acute renal failure following cardiac operation

目的 总结连续性肾脏替代疗法（cRRT）治疗心内直视术后急性肾功能衰竭（ARF）的经验。方法 1999年1月至2005年5月共发生51例心内直视术后急性肾功能衰竭患者，均采用CRRT进行治疗。结果 存活的30例患者在CRRT治疗12h后血气和电解质明显改善，18-288h进入多尿期，肾功能逐渐恢复正常。死亡的21例患者中早期5例治疗偏晚，肾功能未恢复，最终肾衰死亡，另16例CRRT治疗1周后肾功能均恢复，但因低心排、感染及呼吸循环衰竭等非肾性因素死亡。结论 CRRT是救治心内直视术后并发ARF的有效手段。

AIM To evaluate the effect of continuous renal replacement therapy （CRRT） on acute renal failure （ARF） following cardiac operation. METHODS CRRT therapy was applied to 51 cases of acute renal failure following cardiac operation from January 1999 to May 2005. RESULTS Thirty patients survived. Their blood gas analysis and electrolyte ameliorated obviously after 12-hour CRRT, got into the polyuria stage after 18 ～ 288 h, and their renal function became normal gradually. Twenty patients died, 5 of whom died of renal failure. The renal function of the other 16 patients became normal after 7-day CRRT, but they died of low cardiac output, infection respiratory circulatory failure. CONCLUSION CRRT is an effective method for curing ARF following cardiac operation.