CAJ | 학술논문

目的探讨持续肾替代治疗(CRRT)对肝移植术后急性肾损伤的治疗效果.方法回顾性分析82例肝移植围手术期应用CRRT患者的肾功能情况,对其治疗前后的主要指标进行检测.结果与治疗前比较,治疗后患者丙氨酸氨基转移酶(ALT)、总胆红素(TBil)、血尿素氮(BUN)、肌酐(Cr)、肌酸磷酸激酶(CPK)、C反应蛋白(CPR)、肌酐下降,差异均有统计学意义(P＜0.05).与治疗前比较,CRRT治疗后患者血K+、Na+、Cl-、HCO3-、中心静脉压(CVP)显著好转,差异亦具有统计学意义(P＜0.05).其他生化指标与治疗前比较变化不大,差异无统计学意义(P＞0.05).对开始血滤治疗的时机进行研究显示,在急性肾损伤RIFLE分级Ⅰ级开始血滤治疗的患者肾功能恢复的比例明显高于在F级开始血滤治疗的患者(P＜0.05).结论 CRRT治疗能明显改善肝移植术后急性肾损伤患者的预后.
목적 탐토지속신체대치료(CRRT)대간이식술후급성신손상적치료효과.방법 회고성분석82례간이식위수술기응용CRRT환자적신공능정황,대기치료전후적주요지표진행검측.결과 여치료전비교,치료후환자병안산안기전이매(ALT)、총담홍소(TBil)、혈뇨소담(BUN)、기항(Cr)、기산린산격매(CPK)、C반응단백(CPR)、기항하강,차이균유통계학의의(P＜0.05).여치료전비교,CRRT치료후환자혈K+、Na+、Cl-、HCO3-、중심정맥압(CVP)현저호전,차이역구유통계학의의(P＜0.05).기타생화지표여치료전비교변화불대,차이무통계학의의(P＞0.05).대개시혈려치료적시궤진행연구현시,재급성신손상RIFLE분급Ⅰ급개시혈려치료적환자신공능회복적비례명현고우재F급개시혈려치료적환자(P＜0.05).결론 CRRT치료능명현개선간이식술후급성신손상환자적예후.
Objective To study the therapeutic effect of continuous renal replacement therapy (CRRT) in renal failure after liver transplantation.Methods Renal function in 82 patients who underwent CRRT in the perioperative period of liver transplantation were retrospectively analyzed.Results There were significant differences in ALT,TB,BUN and Cr before and after the treatment (P ＜ 0.05).The differences were significant in glutamic-pyruvic transaminase (ALT),creatinine phosphate kinase (CPK) and C reactive protein (CPR) before and after the treatment (P ＜0.05).There were significant improvements in K+,Na+,Cl-,HCO3-and CVP before and after the treatment (P ＜ 0.05),while the differences were not significant in other biochemical parameters (P ＞ 0.05).This research also looked at the effect of timing of CRRT on renal function recovery.Based on the RIFLE classification of AKI,the ratio of renal function recovery in RIFLE-Ⅰ was significantly higher than RIFLE-F (P ＜ 0.05).Conclusion CRRT treatment significantly improved the prognosis of patients with acute renal failure after liver transplantation.