陕西医学杂志
陝西醫學雜誌
협서의학잡지
SHAANXI MEDICAL JOURNAL
2014年
3期
288-290
,共3页
方志成%郑翔%盛春风%黄云飞
方誌成%鄭翔%盛春風%黃雲飛
방지성%정상%성춘풍%황운비
心力衰竭/治疗%血液透析滤过/方法%老年人
心力衰竭/治療%血液透析濾過/方法%老年人
심력쇠갈/치료%혈액투석려과/방법%노년인
Heart failure/therapy%Hemodiafiltration/method%Aged
目的:观察连续性肾脏替代治疗(CRRT )对老年终末期心功能不全患者的疗效。方法:201例老年终末期心功能不全患者分血液透析组和对照组,脉搏指示连续心输出量监测(PiC-CO)心输出量(CO)、心指数(CI)、血管外肺水(EVLWI)、心率(HR)评估血流动力学,测定血浆脑型利钠肽(BNP)评估心功能,记录机械通气参数及呼吸机支持力度,测定动脉血气,评估肺功能情况。结果:与对照组相比,血液透析组血流动力学CO(3.47±0.14 vs 4.59±0.37)、CI(3.45±0.24 vs 4.68±0.75)、EVLWI(7.89±0.74 vs 5.67±0.21),BNP(13283.98±173.91 vs 4584.26±94.71),呼吸机支持力度明显下降,动脉血气氧分压(85.32±14.35 vs 101.43±5.87)提高,肺泡-动脉氧分压差(15.38±3.61 vs 7.53±3.54)下降,心肺功能改善。结论:缓慢、连续性血液透析可有效治疗老年终末期心功能不全,与缓慢脱水减轻心脏负担、改善肺功能等有关。
目的:觀察連續性腎髒替代治療(CRRT )對老年終末期心功能不全患者的療效。方法:201例老年終末期心功能不全患者分血液透析組和對照組,脈搏指示連續心輸齣量鑑測(PiC-CO)心輸齣量(CO)、心指數(CI)、血管外肺水(EVLWI)、心率(HR)評估血流動力學,測定血漿腦型利鈉肽(BNP)評估心功能,記錄機械通氣參數及呼吸機支持力度,測定動脈血氣,評估肺功能情況。結果:與對照組相比,血液透析組血流動力學CO(3.47±0.14 vs 4.59±0.37)、CI(3.45±0.24 vs 4.68±0.75)、EVLWI(7.89±0.74 vs 5.67±0.21),BNP(13283.98±173.91 vs 4584.26±94.71),呼吸機支持力度明顯下降,動脈血氣氧分壓(85.32±14.35 vs 101.43±5.87)提高,肺泡-動脈氧分壓差(15.38±3.61 vs 7.53±3.54)下降,心肺功能改善。結論:緩慢、連續性血液透析可有效治療老年終末期心功能不全,與緩慢脫水減輕心髒負擔、改善肺功能等有關。
목적:관찰련속성신장체대치료(CRRT )대노년종말기심공능불전환자적료효。방법:201례노년종말기심공능불전환자분혈액투석조화대조조,맥박지시련속심수출량감측(PiC-CO)심수출량(CO)、심지수(CI)、혈관외폐수(EVLWI)、심솔(HR)평고혈류동역학,측정혈장뇌형리납태(BNP)평고심공능,기록궤계통기삼수급호흡궤지지력도,측정동맥혈기,평고폐공능정황。결과:여대조조상비,혈액투석조혈류동역학CO(3.47±0.14 vs 4.59±0.37)、CI(3.45±0.24 vs 4.68±0.75)、EVLWI(7.89±0.74 vs 5.67±0.21),BNP(13283.98±173.91 vs 4584.26±94.71),호흡궤지지력도명현하강,동맥혈기양분압(85.32±14.35 vs 101.43±5.87)제고,폐포-동맥양분압차(15.38±3.61 vs 7.53±3.54)하강,심폐공능개선。결론:완만、련속성혈액투석가유효치료노년종말기심공능불전,여완만탈수감경심장부담、개선폐공능등유관。
Objective:To observe CRRT insuffi ciency of the old year-end-stage cardiac function of pa-tients .Methods :201 cases of the old year-end final heart function insufficiency were divided into CRRT group and the control group ,PiCCO monitored CO ,CI ,EVLWI ,HR to evaluate the hemodynamic evaluation of cardiac func-tion determination of plasma BNP ,records of mechanical ventilation parameters and ventilator support ,and arterial blood gas was measured to assess lung function situation .Results :Compared with the control group ,CRRT group blood flow dynamics CO (3 .47 ± 0 .14 vs 4 .59 ± 0 .37) ,CI (3 .45 ± 0 .24 vs 4 .68 ± 0 .75) ,EVLWI (7 .89 ± 0 .74 vs 5 .67 ± 0 .21) ,BNP (13283 .98 ± 173 .91 vs 4584 .26 ± 94 .71) ,ventilator support decreased arterial blood gas partial pressure of oxygen (85 .32 ± 14 .35 vs 101 .43 ± 5 .87)improved alveolar-arterial oxygen difference (15 .38 ± 3 .61 vs 7 .53 ± 3 .54) decreased ,heart and lung function improved .Conclusion:continuity hemodialysis can be effective in treating the old year-end final heart function insufficiency ,and slowly dehydrated to alleviate the burden on the heart ,and improve lung function .