慢性肾衰竭患者合并急性心力衰竭的临床特征观察

Observation on the clinical features of patients with CRF and AHF

目的观察慢性肾衰竭患者合并急性心力衰竭的临床特征,分析其相关诱导因素。方法 2009年3月~2011年1月在笔者所在医院接受透析治疗的40例住院患者,对其采取相应的抢救治疗措施。结果 40例患者共被抢救65例次,其中抢救成功62例次（3例患者因抢救无效死亡）,成功率达95.4%,成功患者经过采取以上相应的抢救措施后病情均得到了缓解。患者的血压下降、胸闷和呼吸困难的现象得到缓解,肺部啰音减轻,心率减慢,心力衰竭的情况也有很大程度的好转。结论血液透析不充分,高血压控制不良,贫血,感染,慢性肾衰竭的代谢产物,慢性肾衰竭患者血磷、血钙和甲状旁腺素调节异常等因素均是慢性肾衰竭患者易发生急性心力衰竭的常见诱因,在治疗慢性肾衰竭患者时需特别注意。

Objective In this paper,the clinical features of patients with chronic renal failure were observed,and also the relevant induced factors of CRF were analyzed. Methods The selected 40 cases,who received a dialysis treatment in Taishan hospital of traditional Chinese medicine from March 2009 to January 2011,as clinical data in this paper. Relevant rescue treatment measures were taken for these 40 cases. Results 40 cases were rescued for 65 times totally,among which rescue was successful for 62 times （3 cases died because of invalid rescue）. Therefore,the successful rate was 95.4%;the conditions of the cases receiving successful rescue were alleviated after treated with the above relevant rescue measures. The blood pressure fall chest tightness and breathing difficulties of patients were alleviated. Also,rale in the lungs of patients was lower,the heart rate was slower,and simultaneously the heart failure was greatly improved. Conclusion The factors such as inadequate blood dialysis,poor hypertension control,anemia,infection,chronic renal failure＇s metabolites,and the hyperphosphatemia,blood calcium and abnormal parathyroid hormone control of patients with CRF are the common incentives for the patients with CRF to easily suffer AHF. Therefore,all these should be specially emphasized by doctors when patients with CRF are treated.