连续低效每日透析滤过治疗急性重症肾损伤的临床观察

Effect of sustained low-efficiency daily diafdtration in patients with critical acute kidney injury

目的观察连续低效每日透析滤过（SLEDD—f）治疗急性重症肾损伤患者的临床疗效及安全性。方法收集我院2006～2010年急性重症肾损伤患者49例，并将其分为连续低效每日透析滤过组（观察组）和连续性肾脏替代治疗组（对照组）。连续性肾脏替代治疗组患者全部行连续性静脉．静脉血液滤过（CVVH）治疗，比较两组患者的临床疗效及治疗并发症。结果观察组患者治疗有效率与死亡率分别为81．82％和9．09％，对照组分别为77．78％和7．41％，两组比较差异无统计学意义（P〉0．05）。观察组尿量恢复时间为（8．7±2．6）天，对照组为（9．5±2．3）天，观察组治疗人均9．18次，对照组8．45次，两组比较差异无统计学意义（P〉0．05）。对照组每次平均23．4小时，低分子肝素用量为17000U／d；观察组每次平均8．5小时，低分子肝素用量为6000U／d，两组比较差异有统计学意义（P〈0．05）。结论连续低效每日透析滤过治疗急性重症肾损伤的疗效与连续性肾脏替代治疗相当，但治疗时间更短，肝素用量少，治疗费用低。

Objective To investigate the effect and safety of sustained low-efficiency daily diafil- tration（SLEDD-f） in patients with critical acute kidney injury. Methods 49 hospitalized patients with critical acute kidney injury and received either CRRT（ Group C） or SLEDD-f（ Group T） treatment were chosen from January,2006 to December,2010. All the patints in Group C were treated with continuous venovenous hemofiltration〈 CVVH） treatment. The effective rate, mortality, CRRT and SLEDD-f treatment time and the complications were observed before and 30 days after treatment in each group. Results The effective rate and mortality of Group T and Group C were 81.82% vs 77.78% ,9.09% vs 7.41% （P 〉 0.05 ）. The time of urinary volume more than 0.5 ml/（ kg ~ d） of Group T and Group C was 8.7 ±2.6 days and 9.5 ± 2.3 days （ P 〉 0.05 ）. Low molecular heparin dosage of Group T and Group C was 6000 U/d and 17000 U/d （P 〈 0.05 ）. Conclusions SLEDD-f used in the treatment of critical acute kidney injury was safe and effective, it could be the alternative of CRRT, and compared to CRRT,there was more advantages such as decreased heparin dosage,decreased therapy time,low hospitalization cost.