连续性肾脏替代治疗对尿毒症伴心衰患者的治疗效果分析

目的探讨连续性肾脏替代治疗(CRRT)对尿毒症伴心衰患者的治疗效果及其作用机制。方法选取我院行常规血液透析治疗的63例尿毒症伴心衰患者,收治时间2013年1月至2017年1月,其中30例在常规血透、内科治疗的基础上加用CRRT治疗(CRRT组)、33例患者仅采取常规血透、内科治疗(对照组),对比两组患者治疗前后的心功能、血电解质、肾功能指标的变化。结果治疗前,CRRT组和对照组的LVEF%、LVEDd、血浆BNP水平差异均无统计学意义(P>0.05);治疗后,CRRT组患者的LVEF%显著的高于对照组,LVEDd、血浆BNP水平显著的低于对照组,差异有统计学意义(P<0.05)。治疗前,CRRT组和对照组的BUN、Scr水平差异均无统计学意义(P>0.05);治疗后,CRRT组患者的BUN、Scr水平显著的低于对照组,差异有统计学意义(P<0.05)。治疗前,CRRT组和对照组的Na~+、K~+、Cl-、HCO-水平差异均无统计学意义(P>0.05);治疗后,CRRT组患者的Na~+、K~+、Cl-水平显著的低于对照组,HCO-水平高于对照组,差异有统计学意义(P<0.05)。结论 CRRT对尿毒症伴心衰患者的治疗效果较好,有利于患者心功能功能恢复、调节患者的水电解质水平。

Therapeutic Effect Analysis of CRRT in Patients with Uremia and Heart Failure

Objective To explore the therapeutic effect and mechanism of continuous renal replacement therapy( CRRT)in patients with uremia and heart failure.Methods 63 cases of patients with uremia complicated with heart failure undergoing routine hemodialysis in our hospital were selected,who were received and treatedduring January 2013 to January 2017,30 patients receiving CRRT treatment on the basis of routine hemodialysis and medical treatment( CRRT group),while the other 33 patients only receiving routine hemodialysis and medical treatment( control group).Cardiac function,blood electrolytes and renal function indicators of the two groups after treatment were compared with those before treatment. Results Before treatment,the differences of LVEF%,LVEDd and serum BNP between the two groups were not statistically significant( P > 0. 05). After treatment,LVEF% of CRRT group was significantly higher than control group and LVEDd as well as serum BNP level of CRRT group were significantly lower than control group,the differences being statistically significant( P<0. 05).Before treatment,there was no statistically significant difference in BUN and Scr level between CRRT group and control group( P>0. 05).After treatment,BUN and Scr of patients in CRRT group were significantly lower than that in control group,with statistically significant difference( P< 0. 05). Before treatment,there was no statistically significant difference in Na~+,K~+,Cl-and HCO-levels between CRRT group and control group( P>0. 05).After treatment,the Na~+,K~+and Cl-levels of patients in CRRT group were significantly lower than those in control group,and HCO-level of patients in CRRT group was higher than that in control group,the difference being statistically significant( P<0. 05).Conclusion CRRT is effective in the treatment of patients with uremia and heart failure,which is beneficial to the recovery of cardiac function and the regulation of water and electrolyte levels