连续性血液净化治疗老年重症心力衰竭疗效分析

Efficacy of the Continuous Blood Purification Treatment for Elderly Patients with Severe Heart Failure

目的观察连续性血液净化(CBP)治疗老年重症心力衰竭的临床疗效。方法对我院2009年1月至2011年3月CBP治疗的32例老年重症心力衰竭患者的临床资料进行回顾性分析。观察患者治疗前与治疗后24、48、72 h血生化、血气分析、血压、呼吸、心率、氧合指数和左心室射血分数等指标的变化和治疗效果。结果 32例患者显效27例,有效4例,死亡1例,总有效率为96.8%,CBP治疗后31例患者心功能明显改善、水肿明显消退、肺部湿啰音明显减少,血压偏高者有所下降,所有患者治疗后24、48、72 h心率、呼吸、中心静脉压、平均动脉压、氧合指数、血尿素氮、血肌酐及水电酸碱失衡情况与治疗前比较差异均有统计学意义(P<0.01)。结论 CBP技术治疗老年重症心力衰竭患者临床疗效肯定,不良反应发生率低。

Objective To observe the clinical efficacy of continuous blood purification（CBP） treatment of elderly patients with severe heart failure. Methods Clinical data of 32 elderly patients with severe heart failure treated with CBP by our hospital in January 2009 March to 2011 were retrospectively analyzed. Changes of indicators such as blood biochemistry, blood gas analysis, blood pressure, respiration, heart rate, oxygenation index and left ventricular ejection fraction and the treatmetn effect were observed before treatmen and 24h,48h,72h after treatment. Results Among the 52 patients,markedly effect were seen in 27 cases effect seen in 4 cases, death in 1 case, forming a total effective rate of 96.8% ; significant cardie function im provement, obvious edema regression,significantly reduced lung wet rales were seen in 31 patients after CBP treatment ; high blood pressure decreased. All indexes including heart rate, respiratory rate, oxydation index, blood urea nitrogen, serum creatinine, central venous pressure and water-electrolyte imbalance ;24h ,48h ,72h after treatment, were improved significantly compared with them before treatment （ P 〈 0.01 ）. Conclusion CBP treatment for elderly patients with severe heart failure has affirmative clinical effect and low adverse reactions.