不同血液净化方式治疗重症心力衰竭合并肾功能不全的疗效分析

目的：探讨连续性血液净化（CBP）和间歇性血液透析（IHD）的治疗重症心力衰竭合并肾功能不全疗效及预后的差别。方法：回顾性分析2001年6月～2007年12月我科治疗的重症心力衰竭合并肾功能不全需血液净化患者35例的临床资料。结果：与IHD组比较,CBP组患者血肌酐、尿素氮很快下降,并能维持在相对较低的水平;电解质、碳酸氢根、血pH水平较稳定。低血压、心律失常和心功能不全发生率低。CBP组12例存活,7例）死亡;IHD组9例存活,7例死亡,差异有显著性（P〈0.01）。结论：CBP能明显改善重症心力衰竭合并肾功能不全患者的预后,疗效优于IHD。

The Curative Effects of Different Blood Purification Therapy for Severe Heart Failure Patients with Renal Failure

Objective： To investigate the efficacy and prognosis of different blood purification （CBP,IHD）in severe heart failure patients with renal failure. Methods： A total of 35 cases of severe heart failure with renal failure in intensive care unit during June of 2001 to December of 2007 were studied retrospectively. Results： Compared with IHD group, the serum creatinine and blood urea nitrogen in CBP group were decreased quickly, and the inner environment can be kept stabilize. The vital signs were stabilized and the rate of hypotension,arrhythmia were low during CBP therapy. 12 cases in CBP group survived and 7 died, while 9 cases in IHD group survived and 7 died, the significant difference in survival rate was found in two groups（P〈0.05）. Conclusion： Compared with IHD, CBP can improve the prognosis. It is more effective in treatment of severe heart failure patients with renal failure.