连续性血液净化对严重挤压伤致急性肾功能衰竭的治疗作用

目的：观察连续性血液净化（continuous blood purification,CBP）在严重挤压伤致急性肾功能衰竭患者抢救中的疗效。方法选取46例严重挤压伤致急性肾功能衰竭患者,所有患者均给予CBP治疗,统计并分析治疗前后患者的收缩压、舒张压、心率、体温及呼吸频率等生命体征和血尿素（ BUN）、血肌酐（ Scr）、血白细胞（ WBC）、血钾（ K＋）、血钙（ Ca2＋）、乳酸脱氢酶（ LDH）、肌酸激酶（ CK）、血肌红蛋白（ MYO）等指标变化情况。结果急性肾功能衰竭患者治疗后的收缩压、舒张压、心率、体温及呼吸频率等明显优于治疗前,治疗前后差异均有统计学意义（P＜0．01）;治疗后的BUN、Scr、WBC、K＋、Ca2＋、LDH、CK、MYO等指标明显优于治疗前,差异有统计学意义（ P＜0．01）。结论 CBP是抢救严重挤压伤致急性肾功能衰竭患者行之有效的方法,值得临床推广应用。

Application of continuous blood purification in the rescue of acute renal failure induced by severe crush in-jury

Objective To observe the efficacy of continuous blood purification in the rescue of acute renal failure induced by severe crush injury. Methods 46 patients with acute renal failure induced by severe crush injury were chose to study. All the patients were treated with continuous blood purification. Vital signs such as systolic blood pressure, diastolic blood pressure, heart rate, body temperature and respiratory rate, and changes of biochemical markers such as BUN, Scr, WBC, K+, Ca2+, LDH, CK, MYO were analyzed before and after CBP treatment. Results After the CBP treatment, the systolic blood pressure, diastolic blood pressure, heart rate, body temperature and respiratory rate, vital signs of patients with crush syndrome were significantly better than those before CBP treatment, and the pre?treatment and post?treatment data were significantly different( P<0.01); after treatment, the biochemical parameters such as BUN,Scr,WBC,K+,Ca2+,LDH,CK,MYO were significantly better than those before treatment, and the pre?treat?ment and post?treatment data were significantly different ( P<0. 01 ) . Conclusion Continuous blood purification is an effective treatment for acute renal failure induced by severe crush injury, and it is worth popularizing in clinic.