连续性血液净化治疗肾前性氮质血症(附8例分析)

Continuous Blood Purification Treatment of Prerenal Azotemia (Report of 8 Cases)

目的探讨连续性血液净化(CBP)对肾前性氮质血症的治疗效果。方法回顾性分析肾前性氮质血症患者8例,均给予CBP治疗,方案为日间连续性静脉静脉血液透析滤过(CVVHDF)。结果入选患者诱因包括肾病综合征、急性(或慢性基础急性加重)左心功能衰竭、营养不良性低白蛋白血症、肝硬化失代偿期。经CBP治疗后除肝硬化失代偿期患者外,其余7例患者肾功能改善,尿量恢复正常。心功能衰竭患者心功能改善。肝硬化失代偿期患者尿量及肾功能无改善。结论CBP对肾病性低蛋白血症及心源性低灌注所致肾前性氮质血症可能具有较好的效果。

Objective To study the therapeutic effect of continuous blood purification （CBP） on prerenal azotemia. Method Retrospective analysis of 8 cases of prerenal azotemia treated by the diurnal and continuous veno-venous hemodiafiltration （CVVHDF）. Result Incentives include nephrotic syndrome, acute （or chronic basis for acute exacerbation） left heart failure, malnutrition low albumin hyperlipidemia, cirrhosis decompensation. After CBP, 7 patients got improved renal function and normal urine output. Patients with heart failure got improved cardiac function. Patient with decompensated cirrhosis had no improvement of the renal function. Conclusion CBP may execute effect on prerenal azotemia caused by nephrotic hypoproteinemia and low perfusion caused by cardiac.