CRRT结合药物脱水治疗重症急性大面积脑梗死合并低钠血症的临床效果

Clinical effect of CRRT combined with drug dehydration in the treatment of severe acute massive cerebral infarction complicated with hyponatremia

目的观察连续肾脏替代疗法(CRRT)联合药物脱水治疗重症急性大面积脑梗死合并低钠血症的临床效果。方法回顾性分析本院收治的67例重症急性大面积脑梗死合并低钠血症患者的临床资料,根据治疗方法的不同将其分为对照组(n=32)和观察组(n=35)。对照组实施常规内科治疗及药物脱水治疗,观察组在对照组基础上结合CRRT治疗。比较两组患者的治疗效果。结果持续治疗48 h后,观察组的治疗总有效率为94.29%,高于对照组的75.00%(P<0.05)。治疗后,两组患者K+、Na+、Cl-水平均升高,且观察组高于对照组(P<0.05)。治疗后,两组患者的BUN、SCr、GFR水平均显著改善,且观察组优于对照组(P<0.05)。结论重症急性大面积脑梗死患者容易出现低钠血症,而在药物脱水的基础上联合CRRT治疗可改善低钠血症及肾功能,挽救患者生命。

Objective To observe the clinical effect of continuous renal replacement therapy(CRRT)combined with drug dehydration in the treatment of severe acute massive cerebral infarction complicated with hyponatremia.Methods The clinical data of 67 patients with severe acute massive cerebral infarction complicated with hyponatremia admitted in our hospital were retrospectively analyzed.According to different treatment methods,the patients were divided into control group(n=32)and observation group(n=35).The control group received routine medical treatment and drug dehydration treatment,and the observation group was treated with CRRT on the basis of the control group.The treatment effects were compared between the two groups.Results After 48 h of continuous treatment,the total effective rate of treatment in the observation group was 94.29%,which was higher than 75.00%in the control group(P<0.05).After treatment,the levels of K+,Na+and Cl-in both groups increased,and those in the observation group were higher than the control group(P<0.05).After treatment,the levels of BUN,SCr and GFR in the two groups significantly improved,and those in the observation group were better than the control group(P<0.05).Conclusion Patients with severe acute massive cerebral infarction are prone to hyponatremia.Combining with CRRT therapy on the basis of drug dehydration can improve hyponatremia and renal function,and save the life of patients.