连续性肾脏替代疗法治疗心脏外科术后低心排出量合并急性肾损伤患者的效果

Effect of CRRT on LCOS Complicated with AKI Patients After Cardial Surgery

目的:探讨连续性肾脏替代疗法(CRRT)对心脏外科术后低心排出量(LCOS)合并急性肾损伤(AKI)患者的治疗效果。方法:选择我科收治的66例心脏外科术后低心排出量合并急性肾损伤患者,予以连续性肾脏替代疗法。治疗前后计算与观察患者的心排血指数(CI)、生命体征相关指标、肾功能、氧合指数、电解质情况,以及多巴胺用量变化情况。结果:与治疗前比较,治疗后患者的心率(HR)、肺毛细血管楔压/左心房压(PCWP/LAP)、中心静脉压(CVP)、血肌酐(Scr)、尿素氮(BUN)、P3+及多巴胺用量降低明显,而平均动脉压(MAP)、左心室射血分数(LVEF)、CI、氧合指数(PaO2/FiO2)则增加明显,差异具有统计学意义(P<0.05)。K+和Ca2+有所变化,但差异不具有统计学意义(P>0.05)。结论:连续性肾脏替代疗法可较好地改善心脏外科术后低心排出量合并急性肾损伤患者的肾功能以及循环功能,调节机体电解质和酸碱平衡,具有临床推广价值。

Objective:To study the effect of CRRT on LCOS comlicated with AKI in post cardial surgery patients.Methods:A total of 66 patients with LCOS comlicated with AKI post cardial surgery received CRRT treatment in our hospital from January 2008 to January 2017.The parameters of CI,vital signs,renal function,oxygenation index,electrolyte,and the dosage of dopamine were calculated and observed before and after treatment.Results:Compared with the treatment before treatment,the HR,PCWP/LAP,CVP,Scr,BUN,P3+ and dopamine dosage decreased significantly after treatment,while MAP,LVEF,CI,PaO2/FiO2 increased significantly（P<0.05）.concentration of K+and Ca2+ changed,but the difference was not statistically significant（P>0.05）.Conclusion:CRRT treatment helps to improve the circulation and renal function in patients with LCOS comlicated with AKI post cardial surgery.