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血液灌流联合血液透析对危重急性肾衰竭患者的疗效观察 被引量:5

The efficacy of hemoperfusion combined with sustained hemodialysis for critically ill patients with acute renal failure
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摘要 目的 探讨血液灌流联合血液透析对危重急性肾衰竭患者的临床疗效。方法 选择2012年1月-2015年5月我院重症监护室收治的肾性单纯性急性肾功能衰竭患者80例,分为两组,各40例,对照组实施单纯血液透析,观察组则行血液灌流联合血液透析,比较两组治疗前后肾功能变化、炎症细胞因子变化,统计功能恢复时间、住院时间及治疗期间因肾功能衰竭导致并发症发生的情况。结果 治疗后观察组尿素氮和肌酐水平低于治疗前及治疗后对照组,差异有统计学意义(P〈0.05),治疗后观察组TNF-α、IL-6和CRP水平低于治疗前及治疗后对照组,差异有统计学意义(P〈0.05),观察组肾功能恢复时间及住院时间均短于对照组,差异有统计学意义(P〈0.05),观察组发生高钾血症、高镁血症、低钠血症及代谢性酸中毒的比例显著低于对照组,差异有统计学意义(P〈0.05)。结论 血液灌流联合血液透析能缓慢、平稳地清除体内毒素和炎性介质,临床效果更理想,耐受性更高,且并发症少,更利于危重患者急性肾功能衰竭的治疗。 Objective To evaluate the clinical efficacy of hemoperfusion combined with sustained hemodialysis for critically ill patients with acute renal failure. Methods 80 cases from January 2012 to May 2015 in intensive care unit with simple renal acute renal failure were divided into two groups,each 40 cases,the control group was implemented with simple hematodialysis, the observation group was used hemoperfusion combined with continued dialysis,then kidney function before and after treatment were changes in inflammatory cytokines before and after treatment,renal function recovery time and complications during treatment in hospital due to renal failure leading were compared. Results After treatment, The urea nitrogen and creatinine level in the Observation group was lower than before treatment and control group after treatment,with significant difference (P〈0.05),the TNF-α,IL-6 and CRP level in the observation group was lower than that before treatment and control group after treatment respectively,with significant difference (P〈0.05),the renal function recovery time and hospital stay in the observation group was shorter than that of control group respectively,with significant difference (P〈0.05),the hyperkalemia, bypermagnesemia, hyponatremia-and metabolic acidosis proportion in the observation group was lower than that of control group respectively,with significant difference (P〈0.05). Conclusion Hemoperfusion combined with continued dialysis can slow and steady removal of toxins and inflammatory mediators,it can better the clinical results and fewer complications for critically ill patients with acute renal failure,and it has greater tolerance and thus more conducive to critically ill patients with acute renal failure treatment.
作者 高燕
出处 《中国当代医药》 2015年第34期97-99,103,共4页 China Modern Medicine
关键词 血液灌流 血液透析 危重患者 急性肾衰竭 Hemoperfusion Continuous Hemodialysis Criticall Patients Acute Renal Failure
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