摘要
目的:回顾性研究连续性肾脏替代治疗(CRRT)与间歇性血液透析(IHD)治疗重症急性肾衰的疗效及影响预后的因素。方法:收集1978年12月~1998年12月住院的重症ARF患者193例,其中101例行CRRT(CRRT组),92例行IHD(IHD组),回顾性对比分析两组患者的临床资料、疗效和预后。结果:CRRT组60例(594%)存活,41例(406%)死亡,IHD组59例(641%)存活,33例(359%)死亡,两组无差异,但CRRT组病情明显重于IHD组:患者年龄更大,平均动脉压低,APACHEⅡ积分高,衰竭器官数目多,需要机械通气和升压药物的患者数高于IHD组(P<005),CRRT组中存活者平均APACHEⅡ积分与IHD组死亡者相似。CRRT组血流动力学稳定,容量状态精确平衡,氮质血症控制更佳,ARF持续时间缩短。结论:①重症ARF的预后受年龄的影响,与原发病因和疾病严重程度有关;②CRRT治疗重症ARF的疗效优于IHD,能改善重症ARF的预后。
OBJECTIVE Toinvestigatetheefficacyandprognosisofcontinuousrenalreplacementtherapy(CRRT)versusintermittenthemodialysis(IHD)insevereacuterenalfailure(ARF)patients. METHODOLOGY OnehundrendandnintythreesevereARFpatientswhoreceivedrenalsupportbetweenDec1978andDec1998wereinvolvedinthisstudy.Ofthem,101(523%)weretreatedwithCRRT(CRRTgroup)and92(477%)withIHD(IHDgroup). RESULTS Sixty(594%)patientsinCRRTgroupsurvivedtheacutephaseoftheillnessand41(406%)patientsdied,while59(641%)patientsinIHDgroupsurvivedand33(359%)patientsdied,nosignificantdifferenceinsurvivalwasfoundbetweenthetwogroups.AstothepatientswithMODS,24outof26patients(375%)withMODSinCRRTgroupsurvived,whileinIHDgroup8outof44(273%)survived,whichwasmuchhigherinCRRTgroup.PatientsinCRRTgroupweremoreseverelyillasmanifestedbyalowermeanarterialpressure,higherPAACHEscore,moredysfunctionedorgansandmorefrequentrequirementofm
出处
《肾脏病与透析肾移植杂志》
CAS
CSCD
1999年第3期212-216,共5页
Chinese Journal of Nephrology,Dialysis & Transplantation
关键词
肾脏替代治疗
血液透析
急性
肾功能衰竭
ARFCRRTMODSechanicalventilationandvasopressorsupportascomparedwithpatientsinIDHgroup.AndCRRTwasassociatedwithimprovedhemodynamicstability
bettercontroloffluidbalancedandbiochemistry
increasednutritionalintakeandashorterdurationofacuterenalfailure(P<005).