连续性肾脏替代治疗与间歇性血液透析治疗重症急性肾衰的比较研究

Comparative study between continuous renal replacement therapy and intermittent hemodialysis in the treatment of severe acute renal failure

目的分析重症急性肾衰临床分别以间歇性血液透析(Intermittent hemodialysis,IHD)、连续性肾脏替代(Continuous renal replacement therapy,CRRT)治疗的疗效差异。方法以2013年1月～2016年2月期间收治的73例ARF为本次研究对象,按临床治疗不同分为对照组36例(行IHD治疗)和观察组37例(行CRRT治疗),对比不同治疗方式患者肾功能指标水平变化,观察治疗期间不良反应发生,评估患者疗效差异,对患者门诊随访1年半,统计两组患者生存率。结果治疗后两组肾功能水平均优于治疗前,且观察组指标优于对照组,差异有统计学意义(P<0.05);相较于对照组,观察组生存率高、不良反应发生率低(P<0.05);观察组治疗率为94.6%高于对照组的83.3%,差异有统计学意义(P<0.05)。结论重症ARF者临床以CRRT治疗,治疗效果理想,患者肾功能得到显著改善,同时治疗期间不良反应发生少,随访患者生存率较高。

Objective To analyze the difference in efficacy between intermittent hemodialysis(IHD)and continuous renal replacement therapy (CRRT)in the treatment of severe acute renal failure(ARF). Methods A total of 73 ARF patients admitted from January 2013 to February 2016 were included in the study. According to different clinical treatment methods,the patients were divided into the control group (IHD treatment,n=36)and the observation group(CRRT treatment,n=37). The changes of renal function indexes in patients with different treatments were compared. The adverse reactions occurred during the treatment period were observed. The difference in efficacy was evaluated. The patients were followed up for one and a half years,and the survival rate of the two groups was counted. Results After treatment,the renal function levels of the two groups were better than those before treatment,and that of the observation group was better than that of the control group (P<0.05). Compared with the control group,the survival rate was higher and the incidence of adverse reactions was lower in the observation group(P<0.05). The treatment rate of the observation group was 94.6%,which was higher than that of the control group(83.3%)(P<0.05). Conclusion The use of CRRT in the treatment of severe ARF has a satisfactory therapeutic effect. The renal function of patients can be significantly improved,with fewer adverse reactions,and the survival rate of follow-up patients is higher.