持续性静脉—静脉血液滤过治疗老年顽固性充血性心衰的疗效观察

Clinic Therapeutic Observations of CVVH for Treatment of Senile Refractory Heart Failure

目的 探讨持续性静脉-静脉血液滤过治疗老年顽固性充血性心衰的疗效。方法 对应用持续性静脉-静脉血液滤过治疗的16例老年顽固性充血性心衰患者进行回顾性分析。观察所有患者治疗前、治疗过程中平均血压、心率、动脉血氧分压变化。测定治疗前、治疗后8h血清Cr、BUN、K^＋、Na^＋的变化。结果 16例患者全部存活。临床症状明显缓解，7例肾功能完全恢复。用持续性静脉-静脉血液滤过治疗30min后，平均血压、动脉血氧分压显著上升，心率则明显减慢；治疗8h后，血清Cr、BUN、K^＋显著下降，血清Na^＋明显上升（p均〈0．05）。结论 持续性静脉-静脉血液滤过能平稳持续清除水及毒素并保持血流动力学稳定，是治疗老年顽固性充血性心袁的有效方法。

Objective：To discuss the clinic therapeutic effect of CVVH for treatment of Senile Refractory Heart Failure.Method ：A retrospective analysis of sixteen patients with Senile Refractory Heart Failure who were treated with CVVH in our department.Changes of MBP,heart rate and arterial Partial pressure of oxygen were monitored before and during the treatment,furthermore,the difference of concentration for Cr,BUN, K^＋ and Na^＋ in serum was compared before and 8h after the treatment. Results：All 16 patients survived with obvious relief of clinic symptoms,besides, seven patients＇ kidney function was fully recovered.After treated with CVVH for 30 minutes, patients＇MBP, arterial partial pressure of oxygen rose and their heart rate was dropped significantly;after 8h of treatment, concentration for Cr, BUN, K^＋ in serum increased while concentration of Na^＋ decreased substantially（p〈0.05）.Conclusions：CVVH could clean up water and toxin in serum steadily,and keep stable hemodynamic. IT is an effective treatment for Senile Refractory Heart Failure.