连续性血液滤过在肝移植术后并发急性肾功能衰竭中的治疗价值

目的探讨连续性静脉-静脉血液滤过(CVVH)对肝移植术后并发急性肾功能衰竭的临床应用价值。方法应用CVVH对该院的22例肝移植术后并发急性肾功能衰竭的患者进行治疗,比较治疗前、后患者的生命体征,血流动力学,肾、肝功能,电解质,动脉血气分析,凝血象,血小板计数的变化,并观察其病死率,以评价CVVH的治疗效果及不良反应。结果 CVVH治疗后患者生命体征和血流动力学平稳(P<0.05),血清尿素氮和肌酐明显下降,总胆红素和结合胆红素明显下降;高钾血症、低钠血症以及代谢性酸中毒纠正(P<0.05);治疗前、后患者凝血象、血小板计数无明显变化(P>0.05);患者病死率有所下降。CVVH治疗过程中,患者耐受性好,无明显不良反应。结论 CVVH是肝移植术后并发急性肾功能衰竭的有效治疗方法之一。

The therapeutic value of continuous veno-venous hemofiltration in acute renal failure after liver transplantation

Objective To evaluate the therapeutic value of continuous veno-venous hemofiltration(CVVH) in the treatment of acute renal failure(ARF) after liver transplantation.Methods 22 patients with ARF after liver transplantation were treated with CVVH.Their vital signs,hemodynamic,hepatic and renal functions,sera electrolyte,blood gas analysis,thromboxane function and blood platelet count were compared before and after the treatment.The mortality was observed and the efficacy and safety of the treatment were evaluated.Results After CVVH,the vital signs and hemodynamic were improved(P<0.05);serum BUN,Cr,TB and DB were significantly decreased(P<0.05);hyperkalemia,hyponatremia and metabolic acidosis were corrected(P<0.05).But there were no remarkable changes in coagulogram and blood platelet count before and after the treatment(P>0.05).The mortality was to some extent reduced.During the treatment of CVVH,the survivability of the patients was good,without obvious side effects.Conclusion CVVH is an effective and safe treatment for patients with acute renal failure after liver transplantation.