摘要
目的比较连续性肾脏替代疗法（CRRT）和自动腹膜透析（APD）治疗对重症急性肾衰患者的临床疗效差异及其意义。方法回顾性分析2011年1月～2014年1月在琼海市中医院肾内科住院的重症急性肾衰患者79例的临床资料，按照治疗方式的不同将其分为CRRT组（42例）和APD组（37例），收集比较两组患者治疗前后肾功能指标[尿素氮（BUN）、血肌酐（Scr）]、心率（HR）、平均动脉压（MAP）、血清pH值以及血生化指标（K^＋、Na^＋和HCO_3-）的差异。结果两组治疗前BUN和Scr比较差异无统计学意义（P〉0．05）。治疗后CRRT组BUN为（21．28＋9．46）mmol／L，APD组BUN为（17．56＋8．12）mmol／L；CRRT组Scr为（400．23±103．92）μmol／L，APD组Scr为（320．18±102．46）μmol／L；两组比较差异均有统计学意义（均P〈0．05）。两组治疗前HR、MAP和pH值比较差异无统计学意义（P〉0．05）。治疗后CRRT组HR[（96．19±4．69）次／min]高于APD组[（93．46±4．96）次／min]，差异有统计学意义（P〈0．05），两组治疗后MAP和pH值比较差异无统计学意义（P〉0．05）。两组治疗前F、Na^＋和HC03-7]（平比较差异无统计学意义（P〉0．05）。治疗后CRRT组K^＋为（6．46±0．96）mmol／L，高于APD组[（4．96±0．11）mmol／L]；CRRT组Na^＋为（135.46±1．46）mmol／L，低于APD组[（142．29±1．39）mmol／L]；CRRT组HCO_3-为（18．45±4．26）mmol／L，低于APD组[（21．20±3．46）mmol／L]，差异均有统计学意义（均P〈0．05）。结论APD在恢复重症急性肾衰患者的肾功能、纠正电解质和酸碱平衡方面较CRRT效果更明显。值得临床推广实施。
Objective To compare the difference of clinical curative effects and significance of Continuous renal re- placement therapy （CRRT） and automatic peritoneal dialysis （APD） in treating severe acute renal failure. Methods The clinical data of 79 cases of patients with severe acute renal failure hospitalized in Department of Nephrology, Qionghai Hospital of Traditional Chinese Medicine from January 2011 to January 2014 was analyzed retrospectively, and the pa- tients were divided into CRRT group （42 cases） and APD group （37 cases） according to different treating methods. The differences of renal function indexes [blood urea nitrogen （BUN）, serum creatinine （Scr）], heart rate （HR）, mean arterial pressure （MAP）, serum pH value and blood biochemical indexes （K^＋, Na^＋, HCO3-） before and after treatment in the two groups were collected and compared. Results There were no significant differences of BUN and Scr before treatment in the two groups （P 〉 0.05）. After treatment, the BUN of CRRT group was （21.28±9.46） mmol/L, which of APD group was （17.56± 8.12） mmol/L; Scr of CRRT group was （400.23±103.92） μmol/L, which of APD group was （320.18±102.46） μmol/L; there were all statistically significant differences between the two groups （all P 〈 0.05）. There were no significant dif- ferences between the two groups in HR, MAP and pH value before treatment （P 〉 0.05）. After treatment, the HR of CRRT group [（96.19±4.69） times/mini was higher than that of APD group [（93.46±4.96） times/mini, the difference was statistically significant （P 〈 0.05）, while there were no statistically significant differences of MAP and pH value aftertreatment between the two groups （P 〉 0.05）. There were no statistically significant differences of the levels of K^＋, Na^＋ and HCO3- before treatment between the two groups （P 〉 0.05）. After treatment, the level of K^＋ of CRRT group was （6.46±0.96） mmol/L, which was higher than that of APD group [（4.96±0.11） mmol/L]; the level of Na^＋ of CRRT group was （135.46±1.46） mmol/L, which was lower than that of APD group [（142.29±1.39） mmol/L]; the level of HC03- of CRRT group was （18.45±4.26） mmol/L, which was lower than that of APD group [（21.20±3.46） mmol/L], there were all statistically significant differences between the two groups （all P 〈 0.05）. Conclusion APD has a better effect in recovering renal function of patients with severe acute re- nal failure and correcting electrolyte and keeping acid-base balance than CRRT, which is worthy of clinical promotion and implementation.
出处
《中国医药导报》
CAS
2015年第30期17-20,共4页
China Medical Herald
基金
海南省自然科学基金项目(814342)
关键词
连续性肾脏替代疗法
自动腹膜透析
重症急性肾衰
Continuous renal replacement therapy
Automatic peritoneal dialysis
Severe acute renal failure
