当代医学
噹代醫學
당대의학
CHINA CONTEMPORARY MEDICINE
2014年
2期
3-4
,共2页
邹懿%王明初%程宗华%洪艳玲%赵素%姚国媛
鄒懿%王明初%程宗華%洪豔玲%趙素%姚國媛
추의%왕명초%정종화%홍염령%조소%요국원
重症急性肾功能衰竭%连续性肾脏替代治疗%间歇性血液透析治疗
重癥急性腎功能衰竭%連續性腎髒替代治療%間歇性血液透析治療
중증급성신공능쇠갈%련속성신장체대치료%간헐성혈액투석치료
Severe acute renal failure%Continuous renal replacement therapy%Intermittent hemodialysis
目的：对比重症急性肾功能衰竭应用连续性肾脏替代治疗及间歇性血液透析治疗的效果。方法根据患者对治疗方法的遴选意愿分为研究组16例和对照组16例。临床组应用连续性肾脏替代治疗，对照组应用间歇性血液透析治疗。对比两组低血压及心律失常诱发次数，KT/V值，24 h尿量达到600 mL时所经过的天数，并统计死亡人数及死亡率。结果临床组尿素氮治疗前为（38.56±12.26）mmol/L、治疗后为（20.04±6.01）mmol/L，尿肌酐治疗前为（825.31±262.47）mmol/L、治疗后为（402.42±122.14）mmol/L，APACHE-I评分治疗前为（21.4±4.36），治疗后为（14.1±5.37）。对照组尿素氮治疗前为（40.55±11.63）mmol/L、治疗后为（26.21±6.74）mmol/L，尿肌酐治疗前为（729.52±212.64）mmol/L、治疗后为（366.87±101.22）mmol/L， APACHE-I评分治疗前为（19.5±3.02），治疗后为（17.2±4.22）。在治疗后，两组尿素氮、尿肌酐及APACHE-I评分优化性改善非常显著，差异有统计学意义（P＜0.05）。临床组低血压发作次数平均（3.72±1.29）次，心律失常发作次数平均（1.36±2.51）次，KT/V平均值为（1.41±0.13,24）h尿量达到600 mL所经过天数平均值为（15.21±5.13），死亡1例，死亡率为6.25%。对照组低血压发作次数平均（1.88±0.26）次，心律失常发作次数平均（3.73±3.22）次，KT/V平均值为（1.24±0.15）,24h尿量达到600 mL所经过天数平均值为（22.64±8.26），死亡1例，死亡率为6.25%。临床组治疗后低血压及心律失常发生次数显著低于对照组（P＜0.05），其KT/V值显著优于对照组（P＜0.05），其24 h尿量达到600 mL所需天数明显少于对照组（P＜0.05），两组死亡率差异无统计学意义（P＞0.05）。结论重症急性肾功能衰竭应用连续性肾脏替代治疗的效果优于间歇性血液透析治疗。
目的：對比重癥急性腎功能衰竭應用連續性腎髒替代治療及間歇性血液透析治療的效果。方法根據患者對治療方法的遴選意願分為研究組16例和對照組16例。臨床組應用連續性腎髒替代治療，對照組應用間歇性血液透析治療。對比兩組低血壓及心律失常誘髮次數，KT/V值，24 h尿量達到600 mL時所經過的天數，併統計死亡人數及死亡率。結果臨床組尿素氮治療前為（38.56±12.26）mmol/L、治療後為（20.04±6.01）mmol/L，尿肌酐治療前為（825.31±262.47）mmol/L、治療後為（402.42±122.14）mmol/L，APACHE-I評分治療前為（21.4±4.36），治療後為（14.1±5.37）。對照組尿素氮治療前為（40.55±11.63）mmol/L、治療後為（26.21±6.74）mmol/L，尿肌酐治療前為（729.52±212.64）mmol/L、治療後為（366.87±101.22）mmol/L， APACHE-I評分治療前為（19.5±3.02），治療後為（17.2±4.22）。在治療後，兩組尿素氮、尿肌酐及APACHE-I評分優化性改善非常顯著，差異有統計學意義（P＜0.05）。臨床組低血壓髮作次數平均（3.72±1.29）次，心律失常髮作次數平均（1.36±2.51）次，KT/V平均值為（1.41±0.13,24）h尿量達到600 mL所經過天數平均值為（15.21±5.13），死亡1例，死亡率為6.25%。對照組低血壓髮作次數平均（1.88±0.26）次，心律失常髮作次數平均（3.73±3.22）次，KT/V平均值為（1.24±0.15）,24h尿量達到600 mL所經過天數平均值為（22.64±8.26），死亡1例，死亡率為6.25%。臨床組治療後低血壓及心律失常髮生次數顯著低于對照組（P＜0.05），其KT/V值顯著優于對照組（P＜0.05），其24 h尿量達到600 mL所需天數明顯少于對照組（P＜0.05），兩組死亡率差異無統計學意義（P＞0.05）。結論重癥急性腎功能衰竭應用連續性腎髒替代治療的效果優于間歇性血液透析治療。
목적：대비중증급성신공능쇠갈응용련속성신장체대치료급간헐성혈액투석치료적효과。방법근거환자대치료방법적린선의원분위연구조16례화대조조16례。림상조응용련속성신장체대치료，대조조응용간헐성혈액투석치료。대비량조저혈압급심률실상유발차수，KT/V치，24 h뇨량체도600 mL시소경과적천수，병통계사망인수급사망솔。결과림상조뇨소담치료전위（38.56±12.26）mmol/L、치료후위（20.04±6.01）mmol/L，뇨기항치료전위（825.31±262.47）mmol/L、치료후위（402.42±122.14）mmol/L，APACHE-I평분치료전위（21.4±4.36），치료후위（14.1±5.37）。대조조뇨소담치료전위（40.55±11.63）mmol/L、치료후위（26.21±6.74）mmol/L，뇨기항치료전위（729.52±212.64）mmol/L、치료후위（366.87±101.22）mmol/L， APACHE-I평분치료전위（19.5±3.02），치료후위（17.2±4.22）。재치료후，량조뇨소담、뇨기항급APACHE-I평분우화성개선비상현저，차이유통계학의의（P＜0.05）。림상조저혈압발작차수평균（3.72±1.29）차，심률실상발작차수평균（1.36±2.51）차，KT/V평균치위（1.41±0.13,24）h뇨량체도600 mL소경과천수평균치위（15.21±5.13），사망1례，사망솔위6.25%。대조조저혈압발작차수평균（1.88±0.26）차，심률실상발작차수평균（3.73±3.22）차，KT/V평균치위（1.24±0.15）,24h뇨량체도600 mL소경과천수평균치위（22.64±8.26），사망1례，사망솔위6.25%。림상조치료후저혈압급심률실상발생차수현저저우대조조（P＜0.05），기KT/V치현저우우대조조（P＜0.05），기24 h뇨량체도600 mL소수천수명현소우대조조（P＜0.05），량조사망솔차이무통계학의의（P＞0.05）。결론중증급성신공능쇠갈응용련속성신장체대치료적효과우우간헐성혈액투석치료。
Objective To compare the treatment of severe acute renal failure with continuous renal replacement therapy and intermittent hemodialysis therapy. Methods According to the patients for treatment selection will be divided into study group 16 cases and control group with 16 cases. Clinical application of continuous renal replacement therapy, the control group using intermittent hemodialysis. Comparing the two groups of hypotension and arrhythmia induction frequency, KT/V value, the number of days after 24 h urine volume reaches 600 mL, and the death toll and mortality. Results The clinical group of urea nitrogen before treatment was(38.56±12.26)mmol/L,(20.04±6.01)mmol/L after treatment, urinary creatinine before treatment was(825.31±262.47)mmol/L,(402.42±122.14)mmol/L after treatment, APACHE-II score before treatment was (21.4±4.36),(14.1±5.37)after treatment. The control group of urea nitrogen before treatment was(40.55±11.63)mmol/L,(26.21±6.74)mmol/L after treatment, urinary creatinine before treatment was(729.52±212.64)mmol/L,(366.87±101.22)mmol/L after treatment, APACHE-II score before treatment was(19.5±3.02),(17.2±4.22)after treatment. After treatment, two groups of urea nitrogen, creatinine and APACHE-II score optimization improvement is very significant, the difference was statistically significant (P<0.05). Episode number average(3.72±1.29)clinical groups hypotension episodes, with an average of (1.36±2.51) arrhythmia, the average value of KT/V by an average of (15.21±5.13) days was (1.41±0.13),24 h urine volume reached 600 mL, 1 people died, the mortality was 6.25%. The control group hypotensive episodes with an average of (1.88±0.26) times, with an average of (3.73±3.22) episodes of arrhythmia, the average value of KT/V by an average of (22.64±8.26) days was (1.24±0.15),24 h urine volume reached 600 mL, 1 people died, the mortality was 6.25%. Clinical treatment of hypotension and arrhythmia incidence was significantly lower than the control group (P<0.05), the KT/V was significantly better than the control group (P<0.05), the 24 h urinary volume reached 600 mL the number of days required significantly less than the control group (P<0.05), no statistically significant difference between the two groups (P>0.05) mortality. Conclusion Effect is better than that of intermittent hemodialysis in severe acute renal failure with continuous renal replacement therapy.
