连续性肾脏替代治疗在移植肾功能延迟恢复治疗中的应用

Effects of continuous renal replacement therapy on delayed graft function after renal transplantation

目的 探讨连续性肾脏替代治疗 (CRRT)在移植肾功能延迟恢复 (DGF)治疗中的疗效 ,并与间断血液透析 (IHD)在DGF中疗效作比较。方法 尸肾移植术后早期出现少尿或无尿 ,诊断为移植肾功能延迟恢复患者 2 2例。早期 10例行IHD ,近期12例根据患者病情的需要分别采用日间缓慢连续性超滤 (SCUF)、连续性动 静脉血液滤过 (CAVHDF) ,观察对比CRRT组和IHD组治疗DGF后血肌酐、尿素氮、2 4h尿量、移植肾超声的变化及 1年后血肌酐水平。结果 所有患者移植肾功能均恢复正常 ,但CRRT组等待移植肾功能恢复时间明显短于IHD组。结论 连续性肾脏替代治疗在尸肾移植术后肾功能延迟恢复的治疗上优于间断血液透析 ,能明显提高移植肾短期存活率。

Objective To investigate the effects of continuous renal replacement therapy(CRRT)on delayed graft function and to compare the effects of CRRT and that of intermittent hemodialysis(IHD).Methods 22 patients with Oliguria or anuresis after cadaveric renal transplantation were diagnosised delayed graft function.Slow continuous ultrafiltration (SCUF)or continuous arterio venous hemofiltration(CAVHF) were applied on 12 patients according to their needs recently while IHD was applied on 10 patients at early time.Blood creatine,blood uria nitrogen,their urine volume,ultrasonic changes and a year later's blood creatine were observed and compared between group CRRT and group IHD.Results Renal function recovered in all patients at last.But the times of waiting renal function recovery of group SRRT werr less than that of group IHD.Conclusion The effects of continuous renal replacement therapy on delayed graft function are superior to that of intermittent hemodialysis.And CRRT is helpful to improve transplanted kidney's a year servivor.