血液透析滤过治疗挤压综合征的临床效果观察

Influence of hemodiafiltration for crush syndrome

目的观察血液透析滤过(hemodiafiltration,HDF)对挤压综合征的治疗效果,探讨HDF治疗挤压综合征的临床应用价值。方法将34例确诊为挤压综合征患者,分为HDF(血液透析滤过)组18例,HD组(血液透析)16例,测定两组治疗前后血红蛋白(HGB)、血白细胞(WBC)、肌酐(Scr)、尿素氮(BUN)、肌红蛋白(Mb)、血钾(K+)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、C反应蛋白(CRP)等生化指标,并观察两组心律失常、消化道出血发生率、住院时间及病死率。结果两组患者各项生化指标均有改善,HDF组比HD组改善更明显的指标有:WBC、Scr、BUN、Mb、CRP;两组患者比较,HDF组并发症减少,住院时间明显缩短。结论 HDF可显著改善挤压综合征预后,其治疗效果优于HD。

Objective Hemodiafiltration （hemodiafiltration HDF） is the main treatment of hemodialysis patients with crush syndrome, and the treatment effect was evaluated in this study. Methods 34 patients with crush syndrome were randomly divided into two groups： 18 patients in HDF group and 16 patients in hemodialysis （HD） group. The level of hemoglobin （HGB）, white blood cell （WBC）, creatinine （Scr）, urea nitrogen（BUN）, myohemoglobin（Mb）, serum potassium （K ＋ ）, prothrombin time （PT）, activated partial thromboplastin time （APTT）, C-reaction protein （CRP）, arrhythmia, incidence of gas- trointestinal bleeding, were measured at the beginning and just after the trial. Results The biochemical indicators of the patients in two groups have improved. Compared the patients in HDF group, the WBC, Scr, BUN, Mb, CRP these patients had a better results. Besides, the complication and length of stay of patients in HDF group obviously reduced, respectively. Conclusion HDF could significantly improve the treatment effect of crush syndrome.