重症急性肾功能衰竭连续性肾脏替代治疗与间歇性血液透析

Treatment of Severe Acute Renal Failure with Continuous Renal Replacement Therapy and Intermittent Hemodialysis

目的 比较连续性肾脏替代治疗 (CRRT)与间歇性血液透析 (IHD)治疗重症急性肾功能衰竭 (ARF)的疗效。 方法 ARF重症患者 75例 ,CRRT组 33例 ,IHD组 4 2例 ,回顾性对比分析两组的临床资料和疗效。 结果 CRRT组病情明显重于 IHD组 :患者年龄大 ,平均动脉压低 ,APACHE 积分高 ,衰竭器官数目多 ,需要机械通气和升压药物的患者数高于 IHD组 (P<0 .0 1 )。但 CRRT组存活 2 4例 (72 .7% ) ,死亡 9例 (2 7.3% ) ;IHD组存活 2 3例 (5 4 .8% ) ,死亡 1 9例 (4 5 .2 % )。两组存活率比较差异有极显著性 (P<0 .0 1 )。 结论 CRRT治疗重症ARF的疗效优于 IHD,能提高重症 ARF患者的存活率 ,改善重症

Objective To investigate the efficacy of continuous renal replacement therapy(CRRT) versus intermittent hemodialysis(IHD) in severe acute renal failure(ARF) patients. Methods Seventy|five severe ARF were recruited in this study. Of them, 33 cases were treated with CRRT(CRRT group) and 42 cases with IHD(IHD group). Results Patients in CRRT group were more severely ill as manifested by a lower mean arterial pressure, higher APACHE Ⅱ score, more dysfunctioned organs and more frequent requirement of mechanical ventilation and vasopressor support as compared with patients in IHD group. 24(72 7%) patients in CRRT group survived on the acute phase of the illness and 9(27 3%) patients died, while 23(54 8%) patients in IHD group survived and 19(45 2%) patients died, significant difference in survival was found between the two groups. Conclusion CRRT is the first choice in the treatment of severe ARF patients, for it can offer several distinct advantages and improved survival, particularly in the more severely ill patients.