持续性血滤在心血管疾病伴急性肾衰中的应用

Application of CAVH and CVVH in the treatment of cardiovascular diseases companied with acute renal insufficiency

应用ＣＡＶＨ或ＣＶＶＨ技术救治１２例多种心血管疾病引起心、肾功能衰竭，经药物治疗无效的患者。血滤治疗时间为４～７２ｈ不等，所有患者均有不同程度的症状改善：浮肿消减，心率下降，肺动脉压及肺毛细血管楔嵌压有所下降，心衰控制或部分控制；２例患者尿量恢复至５００ｍｌ／２４ｈ以上，电解质失衡及酸中毒纠正；部分病例血肌酐及血尿素氮水平下降。作者认为，持续性血液滤过技术是抢救各种不同原因心血管疾病造成心、肾功能衰竭的有效治疗方法，但疾病的最终转归主要用决于心脏功能的恢复，早期应用持续性血液滤过治疗效果较佳。

ecently,12 cases of heart insufficiency with renal insufficiency caused by different cardiovascular disease,had been treated by continuous arterio-venous hemofiltration(CAVH)or continnous veni-venous hemofiltration(CVVH). because of the inefficient use of general drugs such as digitoxin,diuretic,vastodiatators and glucocorticoids. Result:After 4～72 hours of blood filtration,all these cases had recovery sympotoms in different degrees:remission of edema,lower of heart rate,decrease of pulmonary artery pressure and pulmonary capillary wedge pressure.The heart insufficiency had been controlled completely or partially.The urine volume of 2 cases increased to more than 500 ml/day ,and their disorder of electrolyte and acidosis had been corrected.A decrease of creatinine and BUN levels was founded in some patients.From this experience we realized that CAVH and CVVH is an efficient therapy of heart failure with renal insufficiency caused by different cardiovascular diseases.