解放军医学院学报
解放軍醫學院學報
해방군의학원학보
Academic Journal of Chinese Pla Medical School
2013年
8期
842-844,879
,共4页
饶芝国%吴梅清%刘丽娜%王旭东
饒芝國%吳梅清%劉麗娜%王旭東
요지국%오매청%류려나%왕욱동
床旁连续血液净化%重症脑卒中%急性肾脏损害
床徬連續血液淨化%重癥腦卒中%急性腎髒損害
상방련속혈액정화%중증뇌졸중%급성신장손해
continuous blood purification at bedside%severe stroke%acute kidney injury
目的探讨床旁连续血液净化治疗重症脑卒中急性肾损害的效果。方法回顾分析2006年1月-2011年8月本院15例重症脑卒中合并急性肾脏损害的患者资料。结果除1例死于丘脑出血，其余病人恢复良好。血液净化治疗前后，血肌酐[(230.67±42.34)μmol/L vs (75.47±22.54)μmol/L]，尿素氮[(18.74±4.17) mmol/L vs (5.35±0.66) mmol/L]，血钾[(6.26±0.38) mmol/L vs (4.16±0.44) mmol/L]，血钠[(158.07±5.16) mmol/L vs (141.60±3.22) mmol/L]，颅内压[(22.73±2.19) mmHg vs (18.40±1.55) mmHg (1 mmHg=0.133 kPa)]，细胞因子IL-1β[(0.95±0.07) ng/ml vs (0.42±0.09) ng/ml]，IL-6[(259.13±24.39) pg/ml vs (216.53±17.61) pg/ml]，24 h尿量[(506±95) ml vs (1449.33±244.20) ml]，格拉斯哥昏迷评分(8.20±1.61 vs 10.33±1.91)。数据变化具统计学意义(P＜0.01)。病人头颅CT检查未见血肿增加。结论对重症脑卒中合并急性肾脏损害患者，床旁连续血液净化治疗能清除细胞因子，恢复肾脏功能，降低颅内压。
目的探討床徬連續血液淨化治療重癥腦卒中急性腎損害的效果。方法迴顧分析2006年1月-2011年8月本院15例重癥腦卒中閤併急性腎髒損害的患者資料。結果除1例死于丘腦齣血，其餘病人恢複良好。血液淨化治療前後，血肌酐[(230.67±42.34)μmol/L vs (75.47±22.54)μmol/L]，尿素氮[(18.74±4.17) mmol/L vs (5.35±0.66) mmol/L]，血鉀[(6.26±0.38) mmol/L vs (4.16±0.44) mmol/L]，血鈉[(158.07±5.16) mmol/L vs (141.60±3.22) mmol/L]，顱內壓[(22.73±2.19) mmHg vs (18.40±1.55) mmHg (1 mmHg=0.133 kPa)]，細胞因子IL-1β[(0.95±0.07) ng/ml vs (0.42±0.09) ng/ml]，IL-6[(259.13±24.39) pg/ml vs (216.53±17.61) pg/ml]，24 h尿量[(506±95) ml vs (1449.33±244.20) ml]，格拉斯哥昏迷評分(8.20±1.61 vs 10.33±1.91)。數據變化具統計學意義(P＜0.01)。病人頭顱CT檢查未見血腫增加。結論對重癥腦卒中閤併急性腎髒損害患者，床徬連續血液淨化治療能清除細胞因子，恢複腎髒功能，降低顱內壓。
목적탐토상방련속혈액정화치료중증뇌졸중급성신손해적효과。방법회고분석2006년1월-2011년8월본원15례중증뇌졸중합병급성신장손해적환자자료。결과제1례사우구뇌출혈，기여병인회복량호。혈액정화치료전후，혈기항[(230.67±42.34)μmol/L vs (75.47±22.54)μmol/L]，뇨소담[(18.74±4.17) mmol/L vs (5.35±0.66) mmol/L]，혈갑[(6.26±0.38) mmol/L vs (4.16±0.44) mmol/L]，혈납[(158.07±5.16) mmol/L vs (141.60±3.22) mmol/L]，로내압[(22.73±2.19) mmHg vs (18.40±1.55) mmHg (1 mmHg=0.133 kPa)]，세포인자IL-1β[(0.95±0.07) ng/ml vs (0.42±0.09) ng/ml]，IL-6[(259.13±24.39) pg/ml vs (216.53±17.61) pg/ml]，24 h뇨량[(506±95) ml vs (1449.33±244.20) ml]，격랍사가혼미평분(8.20±1.61 vs 10.33±1.91)。수거변화구통계학의의(P＜0.01)。병인두로CT검사미견혈종증가。결론대중증뇌졸중합병급성신장손해환자，상방련속혈액정화치료능청제세포인자，회복신장공능，강저로내압。
Objective To study the effect of continuous blood purification (CBP) at bedside in severe stroke patients with acute kidney injury. Methods The clinical data about 15 severe stroke patients with acute kidney injury admitted to our hospital from January 2006 to August 2011 were retrospectively analyzed. Results All the patients except one who died of thalamus bleeding recovered. The serum levels of creatinine, blood urea nitrogen, potassium, sodium, intracranial pressure, IL-lβ, IL-6, 24 h urinary volume, and Glasgow coma score were significantly higher after CBP treatment than before CBP treatment (230.67±42.34μmol/L vs 75.47±22.54μmol/L, 18.74±4.17 mmol/L vs 5.35±0.66 mmol/L, 6.26±0.38 mmol/L vs 4.16±0.44 mmol/L, 158.07±5.16 mmol/L vs 141.60±3.22 mmol/L, 22.73±2.19 mmHg vs 18.40±1.55 mmHg(1 mmHg=0.133 kPa), 0.95±0.07 ng/ml vs 0.42±0.09 ng/ml, 259.13±24.39 pg/ml vs 216.53±17.61 pg/ml, 506±95 ml vs 1 449.33±244.20 ml, 8.20±1.61 vs 10.33±1.91, P<0.01). Head CT scanning revealed no enlarged hematoma. Conclusion CBP at bedside can clear the cytokines, improve the renal function and reduce the intracranial pressure in severe stroke patients with acute kidney injury.
