CAJ | 학술논문

目的比较持续低效血液透析(sustained low-efficiency dialysis,SLED)与连续性血液净化(continuous blood purification,CBP)在危重症患者治疗效果中的差异.方法将长江大学附属第一医院96例危重症患者按血液净化方式的不同分为连续性血液净化(CBP)组和持续低效血液透析(SLED)组,比较两种治疗方式治疗后各项生化指标、住院天数、血流动力学参数、急性生理学与慢性健康状况评分(acute physiology and chronic health evaluation,APACHE)Ⅱ以及存活率和病死率的差异.结果两种血液净化方式治疗后,两组患者血清肌酸激酶同工酶(CK-MB)、肌酸激酶(CK)、肌酐(Cr)、谷草转氨酶(AST)、谷丙转氨酶(ALT)水平,1d、2d、和7d的APACHEⅡ评分均低于治疗前水平,差异具有统计学意义(P ＜0.05)；SLED组与CBP组比较,患者的住院天数、生化指标、APACHEⅡ评分、血流动力学参数以及存活率和病死率差异均无统计学意义(P＞0.05).结论 SLED具有CBP相似的血流动力学稳定性,且两者在危重症患者中的治疗效果相当,SLED为临床治疗危重症提供了一种更经济方便的方式.
목적 비교지속저효혈액투석(sustained low-efficiency dialysis,SLED)여련속성혈액정화(continuous blood purification,CBP)재위중증환자치료효과중적차이.방법 장장강대학부속제일의원96례위중증환자안혈액정화방식적불동분위련속성혈액정화(CBP)조화지속저효혈액투석(SLED)조,비교량충치료방식치료후각항생화지표、주원천수、혈류동역학삼수、급성생이학여만성건강상황평분(acute physiology and chronic health evaluation,APACHE)Ⅱ이급존활솔화병사솔적차이.결과 량충혈액정화방식치료후,량조환자혈청기산격매동공매(CK-MB)、기산격매(CK)、기항(Cr)、곡초전안매(AST)、곡병전안매(ALT)수평,1d、2d、화7d적APACHEⅡ평분균저우치료전수평,차이구유통계학의의(P ＜0.05)；SLED조여CBP조비교,환자적주원천수、생화지표、APACHEⅡ평분、혈류동역학삼수이급존활솔화병사솔차이균무통계학의의(P＞0.05).결론 SLED구유CBP상사적혈류동역학은정성,차량자재위중증환자중적치료효과상당,SLED위림상치료위중증제공료일충경경제방편적방식.
Objective To compare the therapeutic effec between sustained low-efficiency dialysis (SLED) and continuous blood purification (CBP) in critically ill patients.Methods According to the treatment ways,96 critically ill patients were divided into SLED group and CBP group.A comparison was made on the biochemical indicators,in-hospital duration,hemodynamic parameters,acute physiology and chronic health evaluation (APACHE-Ⅱ ),the survival and the mortality rates.Results After treatment,the levels of serum creatine kinase isozyme MB (CK-MB),creatine kinase (CK),creatinine (Cr),glutamic-oxalacetic transaminase (AST),glutamate-pyruvate transaminase (ALT),APACHE Ⅱ score on the 1st,2nd and 7th day were lower than those prior to the treatment in both groups ( P ＜0.05).There were no statistical differences in in-hospital duration, biochemical indicators, APACHE Ⅱ score,hemodynamic parameters,the survival rate and the mortality rate between the two groups (P ＞ 0.05 ).Conclusions SLED has similar hemodynamic stability with CBP,and the two methods have similar treatment effects in critically ill patients.However,SLED can be relatively economical and convenient for critically ill patients in clinical.