中国中西医结合肾病杂志
中國中西醫結閤腎病雜誌
중국중서의결합신병잡지
CHINESE JOURNAL OF INTEGRATED TRADITIONAL AND WESTERN NEPHROLOGY
2015年
2期
128-130
,共3页
序贯透析%双水平气道正压通气%连续肾脏替代疗法%终末期肾病%急性左心衰
序貫透析%雙水平氣道正壓通氣%連續腎髒替代療法%終末期腎病%急性左心衰
서관투석%쌍수평기도정압통기%련속신장체대요법%종말기신병%급성좌심쇠
Sequential dialysis ( SD)%Bi-level positive airway pressure ( BiPAP)%Continuous renal replacement ther-apy ( CRRT)%End-stage renal disease ( ESRD)%Acute left heart failure
目的：：观察序贯透析( SD)联合双水平气道正压通气( BiPAP)治疗终末期肾病( ESRD)并发急性左心衰的可行性,以期为ESRD并发急性左心衰的患者提供新的、经济的、安全的治疗思路和方法。方法：选择2013年1月~2014年10月在东莞市清溪医院住院的ESRD并发急性左心衰患者60例为研究对象,随机分成：SD联合BiPAP治疗观察组和连续肾脏替代疗法( CRRT)对照组,每组30例。比较两组肾功能相关临床指标、血气分析指标以及临床疗效。结果：治疗后两组血尿素氮(BUN)、血肌酐(Scr)肾功能指标,钾(K+)、钙(Ca2+)、磷(P3-)均出现显著减低(P<0.05和P<0.01),两组对上述指标的减低作用差异无统计学意义(P>0.05)。治疗后两组氧分压(PaO2)、二氧化碳分压(PaCO2)均得到显著改善(P<0.05和P<0.01),但观察组的改善作用优于对照组(P<0.05)。对照组透析时间为(64.32±12.96)h,显著高于观察组的(51.36±7.92)h,P<0.05。观察组的临床治疗有效率为96.7%(29/30),对照组为93.3%(28/30),两组之间差异无统计学意义(P>0.05)。对照组所用费用约为(9274.5±814.6)元,显著高于观察组的(7116. 2± 658.4)元,P<0.01。结论：SD联合BiPAP治疗ESRD并发急性左心衰临床疗效与CRRT治疗差异无统计学意义,但联合治疗对于患者缺氧的纠正作用优于CRRT治疗,而且联合治疗操作简单,费用大幅减低,有利于基层医院的推广使用。
目的：：觀察序貫透析( SD)聯閤雙水平氣道正壓通氣( BiPAP)治療終末期腎病( ESRD)併髮急性左心衰的可行性,以期為ESRD併髮急性左心衰的患者提供新的、經濟的、安全的治療思路和方法。方法：選擇2013年1月~2014年10月在東莞市清溪醫院住院的ESRD併髮急性左心衰患者60例為研究對象,隨機分成：SD聯閤BiPAP治療觀察組和連續腎髒替代療法( CRRT)對照組,每組30例。比較兩組腎功能相關臨床指標、血氣分析指標以及臨床療效。結果：治療後兩組血尿素氮(BUN)、血肌酐(Scr)腎功能指標,鉀(K+)、鈣(Ca2+)、燐(P3-)均齣現顯著減低(P<0.05和P<0.01),兩組對上述指標的減低作用差異無統計學意義(P>0.05)。治療後兩組氧分壓(PaO2)、二氧化碳分壓(PaCO2)均得到顯著改善(P<0.05和P<0.01),但觀察組的改善作用優于對照組(P<0.05)。對照組透析時間為(64.32±12.96)h,顯著高于觀察組的(51.36±7.92)h,P<0.05。觀察組的臨床治療有效率為96.7%(29/30),對照組為93.3%(28/30),兩組之間差異無統計學意義(P>0.05)。對照組所用費用約為(9274.5±814.6)元,顯著高于觀察組的(7116. 2± 658.4)元,P<0.01。結論：SD聯閤BiPAP治療ESRD併髮急性左心衰臨床療效與CRRT治療差異無統計學意義,但聯閤治療對于患者缺氧的糾正作用優于CRRT治療,而且聯閤治療操作簡單,費用大幅減低,有利于基層醫院的推廣使用。
목적：：관찰서관투석( SD)연합쌍수평기도정압통기( BiPAP)치료종말기신병( ESRD)병발급성좌심쇠적가행성,이기위ESRD병발급성좌심쇠적환자제공신적、경제적、안전적치료사로화방법。방법：선택2013년1월~2014년10월재동완시청계의원주원적ESRD병발급성좌심쇠환자60례위연구대상,수궤분성：SD연합BiPAP치료관찰조화련속신장체대요법( CRRT)대조조,매조30례。비교량조신공능상관림상지표、혈기분석지표이급림상료효。결과：치료후량조혈뇨소담(BUN)、혈기항(Scr)신공능지표,갑(K+)、개(Ca2+)、린(P3-)균출현현저감저(P<0.05화P<0.01),량조대상술지표적감저작용차이무통계학의의(P>0.05)。치료후량조양분압(PaO2)、이양화탄분압(PaCO2)균득도현저개선(P<0.05화P<0.01),단관찰조적개선작용우우대조조(P<0.05)。대조조투석시간위(64.32±12.96)h,현저고우관찰조적(51.36±7.92)h,P<0.05。관찰조적림상치료유효솔위96.7%(29/30),대조조위93.3%(28/30),량조지간차이무통계학의의(P>0.05)。대조조소용비용약위(9274.5±814.6)원,현저고우관찰조적(7116. 2± 658.4)원,P<0.01。결론：SD연합BiPAP치료ESRD병발급성좌심쇠림상료효여CRRT치료차이무통계학의의,단연합치료대우환자결양적규정작용우우CRRT치료,이차연합치료조작간단,비용대폭감저,유리우기층의원적추엄사용。
Objective:To observe the effect of sequential dialysis( SD) combined with BiPAP on patients with end-stage renal disease( ESRD) complicated with acute left heart failure. Methods:60 cases of ESRD patients complicated with acute left heart failure were enrolled in this study. All the patients were divided into:SD combined with BiPAP observation group(n=30) and CRRT control group ( n =30 ) . The renal function indexes, blood gas analysis index and clinical effect were compared between the two groups. Results:After treatment, the BUN, Scr, K+, Ca2+, and P3- was decreased in the two groups (P<0. 05 and P<0. 01). There was no significant difference of above index decreases between the two groups (P>0. 05). After treatment, PaO2 and PaCO2 was improved in the two groups (P>0. 05). However, the changes was better in observation group than that in control group (P<0.05). The dialysis time in control group was (64.32 ±12.96)h, which was significantly higher than that of (51.36 ±7.92)h in observation group (P<0. 05). The clinical effective rate was 96. 7% (29/30) in observation group and 93. 3% (28/30) in control group. There was no significant difference between the two groups (P>0. 05). The expense was (9274. 5 ± 814. 6) yuan in control group, which was higher than that of (7 116.2 ±658.4) yuan in observation group (P<0.01). Conclusion:The clinical effect of SD combined with BiPAP in the treatment of ESRD complicated with acute left heart failure had no significant difference with CRRT treatment. But the combined therapy was better in treating patients with hypoxia, and greatly reduce the cost.
