连续性血液净化治疗心力衰竭Ⅳ级合并肾衰竭患者56例疗效观察

Effects of continuous blood purification in 56 patients with severe heart failure and renal failure

目的 观察和分析连续性血液净化在治疗重症心力衰竭合并肾衰竭中的作用和疗效.方法 应用连续性血液净化技术治疗2010年1月至2013年12月间我院收治的56例药物治疗效果不佳的重症心力衰竭合并肾衰竭的患者,并于治疗前后对患者心率、心脏指数、左室射血分数、心输出量、血肌酐（SCr）、尿素氮（BUN）、Na＋、K＋、Cl进行统计、分析和比较,观察患者心功能、血生化指标改善情况.结果 与治疗前相比,患者治疗后[心率（79.7±9.0）次/min、心脏指数（3.35±0.91）L/（min·m2）、左室射血分数（53.55±10.32）％、心输出量（4.47±0.35） L/min、SCr （392.00±86.32）μmol/L、BUN（11.2±4.5）mmol/L、K＋（4.4±0.5）mmol/L]均优于治疗前[心率（128.2±14.2）次/min,心脏指数（1.96±0.57） L/（min·m2）、左室射血分数（39.25±8.55）％、心输出量（3.08±0.54） L/min、SCr（903.00±106.10） μmol/L、BUN（20.5±9.4）mmol/L、K＋ （5.60±0.97） mmol/L差异具有统计学意义（P＜0.05）;而Na＋、Cl变化不大,无统计学差异（P＞0.05）.结论 连续性血液净化疗效确切,安全性高,是治疗重症心力衰竭合并肾衰竭的有效手段.

Objective To observe and analyze the effect and consequence of continuous blood purification （CBP） in patients with severe heart failure and renal failure.Methods Treat 56 patients with severe heart failure and renal failure with continuous blood purification technology.These pa tients were treated between January 2010 and December 2013 by our hospital with drug therapy before but the effect was not as well as expected.Patientg heart rate,cardiac index,left ventricular ejection fraction,cardiac output,serum creatinine （SCr）,urea nitrogen （BUN）,Na＋,K＋ and Cl were measured,analyzed and compared,and improved conditions of patients＇ cardiac function and serum bi ochemical index were observed.Results After treatment,heart rate（79.7 ± 9.0） Time/min,cardiac index（3.35 ± 0.91） L/（min·m2）,left ventricular ejection fraction（53.55 ± 10.32） ％,cardiac output （4.47±0.35）L/min,SCr（392 ± 86.32） μmol/L,BUN（11.2 ± 4.5） mmol/L,K＋ （4.4 ± 0.5） mmol/L were superior to heart rate （128.2 ± 14.2） Time/min,cardiac index （1.96 ± 0.57） L/（min·m2）,left ventricular ejection fraction（39.25 ± 8.55）％,cardiac output （3.08 ± 0.54）L/min,SCr （903 ± 106.1）μmol/L,BUN （20.5 ± 9.4） mmol/L,K＋ （5.6 ± 0.97） mmol/L before treatment,and the difference was of statistical significance（P＜0.05）.Na＋ and Cl didn＇t change much so their distinction didn＇t prove a statistical significance.The clinical effect of CBP is reliable.Conclusions CBP treatment shows accurate curative effect and high safety,and it is an effective way to cure severe heart failure and renal failure.