CAJ | 학술논문

目的：探讨连续性血液净化治疗急性左心衰竭合并肾功能不全的临床疗效及安全性。方法选取2012年1月-2013年12月收治的急性重症左心衰竭合并肾功能不全患者31例，均在常规治疗的基础上行连续性血液净化，比较患者临床转归及各项指标的变化。结果31例患者治疗后显效18例，有效12例，无效1例，治疗总有效率为96贩．77％；治疗后患者的心率、血压、血氧饱和度（SpO2）、左室射血分数（LVEF）、N-末端脑钠肽前体（NT-proBNP）有明显改善，治疗前后比较差异有统计学意义（ P ＜0．05）；治疗后BUN、SCr等肾功能指标亦显著改善，差异具有统计学意义（ P ＜0．05）。结论采用连续性血液净化方法治疗急性左心衰竭合并肾功能不全有较高疗效。治疗过程中无出血、感染等血液净化相关并发症出现，安全性高，值得临床应用。
목적：탐토련속성혈액정화치료급성좌심쇠갈합병신공능불전적림상료효급안전성。방법선취2012년1월-2013년12월수치적급성중증좌심쇠갈합병신공능불전환자31례，균재상규치료적기출상행련속성혈액정화，비교환자림상전귀급각항지표적변화。결과31례환자치료후현효18례，유효12례，무효1례，치료총유효솔위96판．77％；치료후환자적심솔、혈압、혈양포화도（SpO2）、좌실사혈분수（LVEF）、N-말단뇌납태전체（NT-proBNP）유명현개선，치료전후비교차이유통계학의의（ P ＜0．05）；치료후BUN、SCr등신공능지표역현저개선，차이구유통계학의의（ P ＜0．05）。결론채용련속성혈액정화방법치료급성좌심쇠갈합병신공능불전유교고료효。치료과정중무출혈、감염등혈액정화상관병발증출현，안전성고，치득림상응용。
Objective To observe the clinical therapeutic effect and safety of continuous blood purification in the treatment of acute left heart failure and renal insufficiency .Methods The clinical data of 31 patients who underwent acute left heart failure and renal insufficiency in our hospital during January 2012 and December 2013 were collected , the whole patients were taken with continuous blood purification based on routine treatment .The changes of indexes of patients before and after treatment were observed .Results There were 31 cases received treatment , 18 cases with excellent effect , 12 cases with effec-tive effect, 1 case was invalid, the total effective rate was 96.77%;after treatment, blood pressure, heart rate, oxygen satu-ration(SpO2),N-terminal B-type natriuretic peptide(NT-proBNP),left ventricular ejection fraction(LVEF) of patients were improved significantly compared with those before treatment , the difference was statistically significance ( P <0.05); after treatment, BUN, SCr and other indexes of renal function were improved significantly , the difference was statistically significant ( P <0.05).Conclusion Continuous blood purification method for the treatment of acute left heart failure with renal insuffi -ciency has higher curative effect .In the course of treatment , no bleeding , infection and blood purification related complica-tions were happened , is worthy of clinical application .