每天短时透析治疗慢性肾脏病合并难治性心力衰竭的疗效观察

Study on the effect of daily short-term dialysis in treatment of patients with chronic renal disease complicated with refractory heart failure

目的探讨每天短时透析治疗慢性肾脏病合并难治性心力衰竭的临床疗效。方法收集慢性肾脏病肾衰竭期通过血液透析治疗的患者60例,根据治疗方式的不同进行分组,其中研究组采用每天短时透析的治疗方法,对照组采用常规性血液透析的方法。比较患者在治疗前和治疗后6个月心功能的改善和患者血液生化指标的变化情况。结果研究组治疗6个月后心功能改变的显效率(50.00%)显著高于对照组(26.67%),差异有统计学意义(P<0.05)。两组在治疗前血肌酐、尿素氮、二氧化碳结合力、K^+、Na^+、Ca^(2+)、P^(3+)无统计学差异(P>0.05)。治疗6个月后,研究组血肌酐、尿素氮、K^+、P^(3+)显著低于对照组,血二氧化碳结合力、Na^+显著高于对照组,差异均有显著性(P<0.05)。两组血Ca^(2+)水平在治疗后比较无统计学差异(P>0.05)。结论与常规性血液透析相比,每天短时透析治疗能使慢性肾脏病合并难治性心力衰竭患者的血液生化指标改善幅度更大,心功能改善情况更好,值得临床应用。

Objective To explore the effect of daily short-term dialysis in treatment of patients with chronic renal disease complicated with refractory heart failure. Methods Sixty patients with chronic renal disease at stage of renal failure were treated by hemodialysis. According to different regimens for treatment,patients in study group were treated with short-term dialysis and patients in control group were administrated by routine hemodialysis. The changes in heart function and blood biochemical indexes in these patients of 2 groups were compared before and 6months after the treatment. Results The effective rate（ 50. 00%） in patients of study group was significantly higher than that（ 26. 67%） of patients in control group in 6 months after treatment,and the difference was statistically significant（ P〉0. 05）. There was no significant difference in serum levels of creatinine,urea nitrogen,carbon dioxide binding capacity,levels of K~＋,Na~＋,Ca^（2＋）and P^（3＋） before treatment（ P〉0. 05）.After 6 months of treatment,serum levels of creatinine,urea nitrogen,K~＋,and P^（3 ＋）were significantly lower in the study group than those of control group,and blood carbon dioxide binding capacity and level of Na~＋were significantly higher than those in control group（ P〈0. 05）. There was no significant difference in blood level of Ca^（2＋）between these two groups after treatment（ P〉0. 05）. Conclusion In comparison with conventional hemodialysis,treatment with short-term dialysis can improve the blood biochemical indexes of patients with chronic renal disease complicated with refractory heart failure and improve the cardiac function,hence it is worthy to be clinically applied.