连续性静脉-静脉血液滤过治疗儿童急性肾衰竭的疗效

Curative Effect of Continuous Veno-Venous Hemofiltration Therapy on Acute Renal Failure in Children

目的观察连续性静脉-静脉血液滤过(CVVH)治疗儿童急性肾衰竭(ARF)的疗效及特点。方法研究对象为2003年6月-2009年6月在本院行CVVH治疗的ARF患儿42例(CVVH组)及行血液透析(HD)治疗的ARF患儿51例(HD组)。全部患儿分别于血液净化前后查血气分析及电解质、血BUN及血肌酐(Scr),并对其临床资料进行回顾性分析。采用SPSS 11.0软件进行数据处理。结果 HD组原发病以肾小球疾病为主,CVVH组以严重感染多见。CVVH组和HD组血液净化后血BUN、Scr及Na+水平与血液净化前比较均明显好转(Pa<0.05)。血液净化后CVVH组与HD组上述指标比较差异均无统计学意义(Pa>0.05)。CVVH组代谢性酸中毒、高钾血症或低钾血症全部纠正,HD组代谢性酸中毒9例次和高钾血症1例次未纠正。CVVH组超滤量较HD组大(P<0.05),出现低血压和失衡综合征等并发症较少。结论 CVVH是治疗儿童ARF一种安全、有效的方法。

Objective To investigate the therapeutic effect and characteristics of continuous veno-venous hemofiltration（CVVH） the-rapy on acute renal failure（ARF）in children.Methods Forty-two children with ARF treated by CVVH and 51 children with ARF treated by hemodialysis（HD）were studied.These children with ARF were hospitalized in Guangzhou Women and Children′s Medical Center from Jun.2003 to Jun.2009.The serum Na＋ levels,serum creatinine（Scr） and blood urea nitrogen（BUN） were tested in all children before and after treatment of blood purification.The clinical data were analyzed retrospectively.SPSS 11.0 software was used to analyze the data.Results The primary disease was mainly glomerulonephritis in HD group,while serious infections in CVVH group.BUN,Scr and the serum Na＋ levels in both CVVH group and HD group were significantly improved after blood purification than those before purification（Pa0.05）.After blood purification,there was no difference of BUN,Scr and serum Na＋ levels between CVVH group and HD group（Pa0.05）.In CVVH group,metabolic acidosis,hyperkalemia and hypokalemia were all be corrected,however,9 cases with metabolic acidosis and 1 case with hyperkalemia in group HD were not be corrected.Capacity of ultrafiltration in CVVH group was larger than that in HD group（P0.05）,but less in appearing these complication of hypotension and imbalance syndrome.Conclusion CVVH is an effective and safe renal replacement therapy on ARF in children.