连续性肾脏替代疗法在重症急性肾功能衰竭治疗中的应用

目的 回顾分析连续性肾脏替代疗法（ＣＲＲＴ）在重症急性肾功能衰竭（ＡＲＦ）治疗中的应用和影响预后的因素。方法 １９８６年５月至１９９９年１月用ＣＲＲＴ治疗重症ＡＲＦ患者１０１例,回顾性分析了患者临床特点、ＣＲＲＴ方法和预后。结果 １０１例患者中６０例（５９．４％）度过疾病的急性期（存活组）,４１例（４０．６％）在急性期死亡（死亡组）,对两组患者的临床统计学资料、肾功能衰竭的特点、疾病严重程度（ＡＰ

Treatment of severe acute renal failure with continuous renal replacement therapy

OBJECTIVE: To present the experience in 101 severe acute renal failure (ARF) patients treated with continuous renal replacement therapy (CRRT) in our hospital from May 1986 to January 1999. METHODS: Patients'age, sex, previous health status and characteristics of renal failure were recorded. The acute physiology and chronic health evaluation II (APACHE II) score were calculated before CRRT treatment. RESULTS: 60 (59.4%) patients survived the acute phase of their illness, and 41 (40.6%) patients died. In the survival group, there were significantly less patients with pre-renal causes of renal failure and refractory course of uremia, low APACHE II score before treatment and less need of mechanical ventilation or vasoactive supporting. No difference was found in the percentage of oliguria between the survival and total group. CONCLUSION: CRRT is the treatment of first choice in ARF, especially in those complicated cases with severe parachymal renal diseases. The patients' age, previous health status, APACHE II score before CRRT, delayed occurrence of acute renal failure, need of mechanical ventilation and vasoactive drugs were predictors of a worse prognosis in severe ARF patient.The prognosis of renal type ARF patients improved with CRRT.