重症心脏瓣膜病术后肾功能不全患者连续性肾替代治疗体会

目的总结重症心脏瓣膜术后发生。肾功能不全患者采用连续性肾替代治疗（continuous renal replacement therapy，CRRT）的经验。方法回顾性分析15例重症风湿性心脏瓣膜病术后合并肾功能不全，术后行床旁CRRT治疗，取得了良好效果的患者的临床资料，着重分析CRRT治疗方法和效果。其中10例为主动脉二尖瓣联合瓣膜病变患者，1例为主动脉瓣膜病变患者，其余为二尖瓣合并三尖瓣瓣膜病变患者。术前心功能评估为纽约心脏协会心功能Ⅲ～Ⅳ级，手术前后监测肾功能和尿量，术后行床旁CRRT的治疗．监测。肾功能。结果除1例合并顽固性心力衰竭患者死亡外，其余均治愈，最短5d，最长1个月肾功能恢复。结论重症心脏瓣膜术后肾功能不全患者．尽早行CRRT．效果好．恢复快。

Experience of continuous renal replacement therapy for postoperative renal insufficiency in patient with severe heart valve disease

Objectives To summarize the experience of continuous renal replacement therapy(CRRT) for postoperative renal insufficiency in patient with severe heart valve disease.Methods We retrespectively analyzed the clinical data of 15 patients with severe rheumatic heart valves diseases who got postoperative renal insufficiency and performed CRRT,focusing on method and effect of CRRT.Ten out of 15 were mitral combined with aortic valve disease,one case was aortic valve disease,the others were the mitral valve combin...