连续性肾脏替代治疗在慢性肾衰竭并发急性心肌梗死中的应用

Continuous Renal Replacement Therapy for Chronic Renal Failure Complicated with Acute Myocardial Infarcation

目的 :总结日间连续性肾脏替代治疗 (CRRT)救治慢性肾衰竭并发急性心肌梗死的经验。方法 :对9例慢性肾衰竭常规透析时发生急性心肌梗死的患者改行CRRT ,观察临床效果 ,监测血生化、肾功能。结果 :所有患者经CRRT治疗 ,心前区疼痛、胸闷、憋气均有不同程度缓解 ,7例患者度过急性期 ,平均治疗时间 90～ 14 6h ,转为常规血透 ,目前仍存活 ;2例患者因并发症死亡。结论 :CRRT操作简便 ,对血流动力学影响小 ,日间CRRT同样能有效救治病人 ,使其度过急性期 。

Objective:To study the efficiency and safety of day-time continuous renal replacement therapy (CRRT) for the treatment of chronic renal failure (CRF)complicated with acute myocardial infarction.Methods:Nine CRF patients underwent maintenance dialysis were switched to CRRT because of AMI. Clinical outcomes and serum biochemical parameters were analyzed.Results:Precordial pain, short of breath and dyspnea were improved in all patients following CRRT. Seven patients survived had an average treatment time of 90～146 hours before returned to intermittent hemodialysis. Two patients died of complications. Conclusion:Day-time CRRT is effective and safe in treating AMI with minimal influences on hemodynamics and can reduce the mortality.