连续性肾脏替代疗法治疗急性肾功能衰竭的临床观察

Continuous renal replacement therapy for acute renal failure

目的观察连续性肾脏替代疗法（CRRT）治疗重症急性肾功能衰竭（ARF）的疗效和对预后的影响。方法对2003年以来16例ARF（伴发多器官功能障碍综合征,MODS）患者进行CRRT的临床资料回顾性分析。结果11例患者经CRRT治疗24 h后,生命指征平稳,BUN、Scr下降（P〈0.05）,二氧化碳结合力（CO2CP）正常,85-264h后进入多尿期;5例患者死于严重创伤或MODS。治疗过程中无低体温和低血压等并发症。结论CRRT治疗重症ARF患者,血液动力学稳定,溶质清除率高,有利于营养支持及清除炎性细胞因子,从而改善重症ARF患者的预后。

Objective To evaluate the efficacy and prognostic significance of continuous renal replace-ment therapy on acute renal failure. Methods Clinical characteristics of 16 patients with acute renal failure （ accompanied with multiple organ dysfunction syndromes） were retrospectively studied. Results Vital signs of 11 patients become normal after 24 hours of Continuous renal replacement therapy, BUN and Scr decreased （ P 〈 0. 05 ） , CO2CP became normal, the patients were present with polyuria, 5 patients died of severe trauma and MODS. Conclusion Continuous renal replacement therapy is effective in maintaining stable hemodynamics, re- moving inflammatory mediators and improving the prognosis.