连续性肾替代治疗救治危重患者的临床研究

Clinical study of CRRT in patients with critically ill

目的评价连续性肾替代治疗(CRRT)救治危重患者临床效果。方法选择57例危重患者,其中急性肾功能衰竭(ARF)21例,慢性肾功能衰竭(CRF)8例,难治性心力衰竭3例,电解质紊乱2例,急性中毒9例,多脏器功能障碍综合征(MODS)8例,各种手术后6例,均予CRRT治疗。治疗期间监测患者的血压和心率;治疗前后采血查肝肾功、电解质、血气分析;治疗前、治疗12 h、治疗24 h、治疗结束分别查C反应蛋白(CRP)。结果所有患者治疗期间血压和心率保持稳定,治疗后血尿素氮(BUN)、血肌酐(SCr)均较前下降明显(P均<0.05);其余生化指标均在正常范围内。57例患者中10例死亡,1例放弃治疗,病死率为19%。结论CRRT对危重患者是一种有效的治疗手段,具有广泛的应用前景。

Objective It is to evaluate the clinical effect of continuous renal replacement treatment （CRRT） in patients with critically ill. Methods 57 patients with critically ill were chosen, including 21 cases with acute renal failure （AFR）, 8 cases with chronic renal failure （CRF）, 3 cases with refractoriness heart failure, 2 cases with electrolyte disturbance, 9 cases with acute poisoning, 8 cases with multitude organ disturbance symptom （MODS） and 6 cases with various kinds post-opera- tion. All cases were treated with CRRT. Blood pressure and heart rate were observed during CRRT, hepatic and renal function, electrolytes and blood gas analysis were detected before and after CRRT, C reactive protein （CRP） plasma concentra- tions were assayed before, 12h, 24h and after CRRT. Results Blood pressure and heart rate of all patients was retained stablilization. The levels of blood urea nitrogen （BUN） and serum creatinine were significantly decreased after treatment （P 〈 0.05）, but the other biochemical indicators were remained in normal limits. 10 cases out of 57 died and one patient gave up treatment, mortality was 19 percent. Conclusion CRRT is an effective therapeutic option for patients with critically ill.