连续性血液净化联合腹膜透析在高危尿毒症患者中的应用

目的探讨连续性血液净化（CRRT）联合腹膜透析治疗高危尿毒症患者的临床疗效。方法36例不能耐受普通血液透析、腹透置管的高危尿毒症患者，在原有内科治疗基础上，进行紧急CRRT治疗，待病情基本平稳后，给予腹膜透析治疗，通过观察治疗过程中生命体征包括体温（T）、脉搏（P）、呼吸频率（RR）、平均动脉压（MAP）及首次CRRT治疗前和末次CRRT治疗后血肌酐、尿素氮水平及电解质变化，判断CRRT的疗效。结果所有病例中，2例患者因病情危重抢救无效死亡，余34例经CRRT抢救成功，行腹透治疗后顺利出院，CRRT治疗前后生命体征、电解质紊乱得到显著改善（P〈0．01）。结论CRRT联合腹膜透析有利于高危尿毒症生命体征的稳定，有效地改善病情和电解质紊乱，对高危尿毒症患者治疗中疗效显著。

Application of continuous blood purification and peritoneal dialysis to the treatment of 36 critical uremia patients

Objective To assess the clinical effect of continuous renal replacement therapy(CRRT)combined with peritoneal dialysis(PD)in the treatment of critical uremia patients.Methods 36 critical uremia patients treated by CRRT combined with PD were involved in this study.Vital signs of these patients were recorded during the process.The serum BUN,SCr and electrolytes were analyzed before and after the treatment with CRRT.Results Of all these patients,2 died of severe diseases,other 34 patients discharged from hospital after the treatment of CRRT and PD.The level of serum BUN,SCr and the degree of electrolyte disturbances were significantly improved(P<0.01).Conclusion CRRT with PD may be the best choice in the treatment of critical uremia patients.This method may contribute to improve the survival rate of uremia patients.