大剂量速尿微泵连续输注治疗急性肾功能衰竭临床疗效评价

目的：评估大剂量速尿微泵连续输注治疗急性肾功能衰竭（Acute renal failure，ARF）的有效性。方法选择2011年12月至2013年9月在我院接受治疗的ARF患者84例，按照治疗方式的不同将患者分为观察组和对照组，每组各42例。对照组给予大剂量速尿分次静脉注射治疗，而观察组采用微泵连续输入治疗。统计两组患者治疗前与治疗后3 d内每24 h尿量（24 h UV）、治疗前与治疗3 d后血尿素氮（BUN）和血肌酐（Scr）水平，并统计两组治疗3 d后非少尿型肾衰和需血液净化的比例、28 d死亡率和肾功能恢复时间。结果两组治疗前24 h UV、BUN和Scr水平相比，差异均无统计学意义（P＞0.05）。观察组治疗前3 d每天24 h UV均明显大于对照组，差异有统计学意义（P＜0.05）；观察组治疗3 d后BUN和Scr水平分别为（16.5±5.7） mmol/L和（178.3±80.9）μmol/L，明显低于对照组的（20.2±7.3） mmol/L和（222.4±84.8）μmol/L，差异具有统计学意义（P＜0.05）；观察组治疗3 d后非少尿型肾衰和需血液净化比例明显小于对照组，肾功能恢复时间明显短于对照组，差异均具有统计学意义（P＜0.05）。结论大剂量速尿微泵连续输注治疗ARF的效果显著，能缩短肾功能恢复时间，减少透析比例，值得临床上推广应用。

Clinical observation of continuous infusion of high dose furosemide by intravenous pump in patients with acute renal failure

Objective To evaluate the efficacy of continuous infusion of high dose furosemide by intrave-nous pump in the patients with acute renal failure（ARF）. Methods 84 cases with ARF accepted treatment in our hos-pital from December 2011 to September 2013 were selected, patients were divided into observation group and control group according to the different treatment they accepted, with 42 cases in each group. The observation group was treat-ed with micro-pump maintenance with large doses of furosemide, while the control group received continuous infu-sion of high dose furosemide by intravenous pump. 24 h urine volume （24 hUV） of two groups at before and after 3 d treatment were recorded, blood urea nitrogen （BUN） and serum creatinine （Scr） levels in two groups at before and af-ter 3-d treatment as well as proportion of patient changed to non-oliguric renal failure and who required blood purifica-tion after 3 d treatment, 28 d mortality and renal recovery time were recorded. Results The difference of 24 hUV, BUN and Scr level between two groups before treatment was not statistically significant （all P〉0.05）. each 24 hUV in observation group at the first 3 d were significantly higher than the control group, the difference was of statistically sig-nificant （P〈0.05）;level of BUN and Scr at 3 d after treatment in the observation group was （16.5 ± 5.7） mmol/L and （178.3 ± 80.9）μmol/L, and that were less than the control group which was （20.2 ± 7.3） mmol/L and （222.4 ± 84.8）, the difference was of statistically significant （P〈0.05）;proportion of patient changed to non-oliguric renal failure and who required blood purification 3 d after treatment in observation group was significantly less than in the control group, re-nal function recovery time in observation group was significantly shorter than in the control group, the difference was of statistically significant （P〈0.05）. Conclusion Continuous infusion of high dose furosemide by intravenous pump in patients with