连续性血液净化技术在失代偿性心力衰竭合并急性肾损伤治疗中的临床研究

Clinical research of continuous blood purification technology in treatment of patients with decompensated heart failure in acute kidney injury

目的探讨连续性血液净化技术在失代偿性心力衰竭合并急性肾损伤治疗的临床研究。方法回顾性分析2015年5月~2016年12月于本院收治失代偿性心力衰竭合并急性肾损伤患者60例根据治疗措施不同将其分为试验组及对照组,每组各30例,对照组给予标准治疗+利尿剂强化治疗,试验组给予标准治疗+连续性血液净化治疗,统计分析两组患者治疗前后心率、平均动脉压、血氧饱和度、APACHEⅡ得分、肌酐、尿素氮、葡萄糖及钾的水平情况。结果试验组患者治疗后心率、APACHEⅡ得分均低于对照组,而平均动脉压及血氧饱和度试验组高于对照组,差异均有统计学意义(P<0.05);试验组患者干预后6、24、72h血清肌酐、尿素氮及钾水平均低于对照组,差异有统计学意义(P<0.05),而干预后6、24、72h血清葡萄糖水平两组患者无明显差异(P>0.05)。结论连续性血液净化技术能有效改善失代偿性心力衰竭合并急性肾损伤患者肾功能,同时能改善患者血流动力学,提高临床治疗效果。

Objective To discuss the clinical research of continuous blood purification technology in treatment of patients with decompensated heart failure in acute kidney injury. Methods 60 patients with decompensated heart failure in acute kidney injur in our hospital from April 2015 to December 2016 were selected.According to the treatment measures, they were divided into the experimental group and the control group,each group of 50 cases. Patients in control group were treated with standard treatment＋diuretic therapy intensification,and patients in experimental group were treated with standard therapy＋continuous blood purification therapy.heart rate,mean arterial pressure,blood oxygen saturation,APACHE Ⅱ score,creatinine and urea nitrogen,glucose and potassium levels of all of the patients before and after the treatment were statistical analyzed. Results Heart rate after treatment,the APACHE Ⅱ score of the experimental group was significantly lower than that of the control group,mean arterial pressure and oxygen saturation of the experimental group were significantly higher than those of the control group,there were statistically significant differences （P 〈 0.05）.The serum creatinine and urea nitrogen and potassium levels of 6,24,72h after intervention of the experimental group were significantly lower than those of the control group,there were statistically significant differences（P 〈 0.05）.The serum glucose levels of 6,24,72h after intervention in the two groups had no obvious difference（P 〉 0.05）. Conclusion Continuous blood purification technology can effectively improve decompensated heart failure in patients with acute kidney injury of renal function,at the same time,it can improve hemodynamics,and improve the effect of clinical treatment.