血液透析的不同模式治疗急性肾功能衰竭患者的有效性及对肾功能、电解质的影响

The effectiveness of different hemodialysis modes in treatment of patients with acute renal failure and their effects on renal function and electrolyte

目的探讨血液透析的不同模式治疗急性肾功能衰竭(ARF)患者的有效性。方法按随机数字将68例急性肾功能衰竭患者分为两组,即血液透析组和连续性血液净化组,每组34例,血液透析组采用血液透析模式治疗,连续性血液净化组采用连续性血液净化模式治疗,比较两组治疗效果、透析前后的肾功能指标、电解质和p H的异常情况。结果 (1)两组在年龄、性别、病因、ARF严重程度、透析疗程、肌酐、尿量、尿素氮等临床一般资料方面均无显著性差异(P>0.05);(2)血液透析组治疗的总有效率为73.53%,连续性血液净化组治疗的总有效率为76.47%,两组的治疗总有效率差异无统计学意义(χ2=0.075,P=0.785>0.05);(3)两组透析前的电解质和p H的异常率均无明显差异(P>0.05),透析后,两组的电解质和p H的异常率明显降低,差异具有统计学意义(P<0.05),但连续性血液净化组电解质和p H的异常率明显低于血液透析组,差异具有统计学意义(P<0.05);(4)多因素分析结果显示,年龄是尿素氮和肌酐的影响因素,性别、透析方法等变量与尿素氮和肌酐无统计学关联;(5)连续性血液净化组的血清肌酐、尿素氮低于血液透析组,但差异无统计学意义(P>0.05)。结论血液透析与连续性血液净化方法治疗急性肾功能衰竭的效果较好,均能有效地清除急性肾功能衰竭患者的肌酐、尿素氮,连续性血液净化较血液透析更有效地纠正电解质和p H的异常。

Objective To study the effectiveness of different hemodialysis modes in treatment of patients with acute renal failure.Meth-ods 68 patients with acute renal failure were randomly divided into two groups,namely hemodialysis group and continuous blood puri-fication group,with 34 cases in each group.Hemodialysis group received the treatment of hemodialysis model,while continuous blood purification group received the treatment of continuous blood purification model.Treatment effect,renal function indexes before and after dialysis,and anomalies of electrolyte and pH value between two groups were compared.Results （1 ）age,sex,etiology,ARF severity, dialysis treatment,creatinine,urine volume,urea nitrogen,and other general clinical data in the two groups had no significant difference （P 〉0.05）.（2）total effective rates of hemodialysis group and continuous blood purification group were 73.53% and 76.47%,re-spectively,which had no statistically significant difference （χ^2 =0.075,P =0.785 〉0.05）.（3）the abnormal rate of electrolyte and pH before dialysis in the two groups had no obvious difference （P 〉0.05）.The after dialysis abnormal rate of electrolyte and pH value in the two groups was significantly reduced,also showing statistically significant difference （P 〈0.05）,but this rate in the continuous blood purification group was significantly lower than the hemodialysis group （P 〈0.05）.（4）multi -factor analysis showed that the in-fluence factor of urea nitrogen and creatinine was age,while other variables,such as gender and dialysis method,had no statistical corre-lation with urea nitrogen and creatinine.（5）Serum creatinine and urea nitrogen of continuous blood purification group were lower than the hemodialysis group,but with no significant differences （P 〉0.05）.Conclusions Hemodialysis and continuous blood purification method showed good effects in the treatment of acute renal failure,which can effectively remove creatinine and urea nitrogen in patients with acute renal failure.Besides,continuous blood purification could more effectively correct anomalies of electrolyte and pH compared to hemodialysis.