连续性肾脏替代疗法联合强的松龙治疗原发性肾病综合症合并急性肾功能衰竭的临床研究

Clinical Study on Continuous Renal Replacement Therapy Combined with Prednisolone in Treatment of Primary Nephrotic Syndrome Complicated with Acute Renal Failure

目的探讨连续性肾脏替代疗法联合强的松龙治疗原发性肾病综合症合并急性肾功能衰竭的效果。方法选取我院2016年1月至2019年10月收治的原发性肾病综合症合并急性肾功能衰竭患者92例,采用数字表法随机分为对照组与联合组,两组患者均行常规治疗,对照组在常规治疗基础上给予强的松龙,联合组在对照组基础上联合连续性肾脏替代疗法干预。对比两组患者临床疗效,观察两组患者治疗前后BUN、Cr、K^(+)、Na^(+)及HCO_(3)^(-)水平。对比患者临床检查情况。结果联合组治疗总有效率82.61%明显高于对照组60.87%(P<0.05);治疗前,两组患者BUN、Cr、K^(+)、Na^(+)、HCO_(3)^(-)指标水平无显著差异(P>0.05);治疗后,联合组BUN、Cr、K^(+)水平均低于对照组,Na^(+)、HCO3-水平高于对照组(P<0.05);联合组心律失常、低血压发作次数及24h尿量恢复情况与对照组相比差异显著(P<0.05)。结论原发性肾病综合症合并急性肾功能衰竭患者借助CRRT联合强的松龙治疗的效果显著,值得临床推广应用。

Objective To explore the effect of continuous renal replacement therapy combined with prednisolone in treatment of primary nephrotic syndrome complicated with acute renal failure.Methods 92 cases of patients with primary nephrotic syndrome complicated with acute renal failure treated in our hospital from January 2016 to October 2019 were selected,and were divided into control group and combination group according to digital table method.All the two groups were given routine treatment,and the control group were given prednisolone on the basis of the routine treatment,and the combination group were combined with continuous renal replacement therapy on the basis of the control group.Clinical effects were contrasted in the two groups,and levels of BUN,Cr,K^(+),Na^(+) and HCO_(3)^(-) were observed in the two groups.Clinical examination of the patients were contrasted.Results The total effective rate of the combination group was 82.61% significantly higher than that of 60.87% of the control group(P<0.05).Before treatment,there were no significant differences in BUN,Cr,K^(+),Na^(+) and HCO_(3)^(-)indexes between the two groups(P>0.05).After treatment,the levels of K^(+),Cr and BUN in the combined group were all lower than those in the control group,and levels of Na^(+)and HCO_(3)^(-) were higher than those of the control group(P<0.05).Arrhythmia frequency,episodes of low blood pressure and 24h urine volume recovery in the combination group were significantly different from those in the control group(P<0.05).Conclusion The effect is obvious for patients with primary nephrotic syndrome complicated with acute renal failure to treat with CRRT combined with prednisolone.It is worthy of clinical popularization and application.