连续肾脏替代治疗对肝移植术后感染的治疗作用

目的探讨连续性肾脏替代治疗（CRRT）对肝移植感染急性肾功能衰竭的治疗作用。方法回顾性分析36例肝移植术后感染的病例，其中急性肾功能衰竭24例，15例接受了CRRT治疗，观察其死亡率、治疗前后生命体征、血流动力学、血电解质和酸碱平衡、肝、肾功能变化和副作用。结果CRRT能降低肝移植感染急性肾功能衰竭死亡相对危险度（RR=1．00，95％CI0．02～50．40），改善患者生命体征和血流动力学（P〈0．05），纠正电解质和酸碱平衡紊乱（P〈0．05），改善肝、肾功能（P〈0．05），治疗过程中，副作用少，患者耐受性好。结论CRRT可望成为肝移植感染急性肾功能衰竭的有效治疗方法之一。

The therapeutic effectiveness of continuous renal replacement therapy in the acute renal failure resulting from infection after liver transplantation

Objective To evaluate the curative efficacies of continuous renal replacement therapy （CRRT） in the acute renal failure due to infection after liver transplantation. Methods The clinical data of the 24 liver transplantation receptors who had developed acute renal failure （ARF） resulted from infection were analyzed. Among them, 15 accepted CRRT. Their mortalities, vital signs, hemodynamics, sera electronics and acid alkali balance, liver and kidney functions, and side effects were compared before and after the treatment. Results To ARF due to infection after liver transplantation, CRRT could reduce the mortality and death relative risk （95% confidence interval 0.02 -50.40） , improve the vital signs and hemodynamics （P 〈 0.05 ） , correct the sera electronics and acid alkali imbalances, ameliorate the new liver and kidney functions （P 〈 0.05）, simultaneously, without obvious side effects. Conclusion The CRRT is an important treatment for the ARF caused by infection after liver transplantation.