连续性血液净化治疗危重症46例临床分析

目的 :回顾性分析连续性血液净化治疗重症急性肾功能衰竭和多脏器功能衰竭的疗效和影响预后的因素。方法 :46例连续性血液净化治疗病例均来自我院加强治疗科 1995年以来接受连续性血液净化治疗的病人。应用连续性动 静脉血液滤过 2例 ,连续性静 静脉血液滤过 8例 ,连续性动 静脉血液透析滤过 2例 ,连续性静 静脉血液透析滤过 2 9例 ,连续性血浆滤过吸附 5例。结果 :46例经连续性血液净化治疗后尿素氮、肌酐和水、电解质、酸碱失衡均得到较好的控制 ,以存活组较满意 ;在治疗过程中 ,血流动力学稳定。 46例中死亡 2 7例 ,存活 19例 ,死亡原因与年龄、疾病严重程度等因素有关。结论 :连续性血液净化能有效地清除溶质和水分 ,且有十分稳定的血流动力学 ,是治疗重症急性肾功能衰竭和多脏器功能衰竭的有效方法

Clinical analysis on continuous renal replacement in 46 severe patients

Objective To retrospectively analyze the effect of continuous renal replacement on severe renal failure and multiple organ failure,and the factors affecting prognosis .Methods Forty-six cases were treated with continuous renal replacement from 1995 to 2002 in our hospital including continuous arteral-venous hemofiltration in 2 case,continuous venous-venous hemofiltration in 8 cases,continuous arteral-venous hemodialysis filtration in 2 cases,continuous venous-venous hemodialysis filtration in 29 cases and continuous plamas filtration absorption in 5 cases. Results BUN,Cr,edema,electricity and acid-base disturbance of 46 patients were well controlled in 19 survived patients.The other 27 patients died.The death causes were much concerned to age,severity of disease and other factors.Conclusion Continuous renal replacement could clearly eliminate BUN,Cr and edema with stable hemodynamics and it is an effective method for severe acute renal failure and multiple organ failure.