摘要
目的 探讨连续性静脉静脉血液滤过（CVVH）治疗慢性肾功能不全（CRF）伴充血性心力衰竭（CHF）患者的临床疗效及影响预后的因素。方法 对上海交通大学第六医院2002年1月～2005年2月的42例CRF伴CHF的患者接受CVVH治疗，观察治疗前后心率（HR）、呼吸（RR）、血压(BP)、心功能改善情况及 APACHEⅡ评分等指标变化，并检测血肌酐(Scr)、尿素氮（BUN）、血碳酸氢根浓度（HCO3-）、动脉血pH值（pH）。结果 CVVH 治疗能明显减少CRF伴CHF患者的水、钠潴留，改善心功能，降低APACHEⅡ评分。对死亡组和存活组进行统计学分析发现死亡组APACHEⅡ评分更高，而容量负荷（FO%）与死亡率密切相关。结论 CRF伴CHF患者在血肌酐不高的情况下，如容量负荷过重即行CVVH治疗，可减少并发症，降低死亡率。
Abstract
Objective To investigate the clinical efficacy of continuous venovenous hemofiltration(CVVH) in treating chronic renal failure(CRF) patients with congestive heart failure(CHF). Methods Fourty-two CRF with CHF patients received CVVH. In all patients, heart rates, respiration rates, blood pressure , the changes of heart function and APACHEⅡ score were observed, serum creatinine (SCr), blood urea nitrogen (BUN) were detected. Results The treatment of CVVH could reduce sodium and water retention, and improve the heart function. Statistical analysis were used in survivors and nonsurvivors. The APACHEⅡ scores of the non-survivors were higher than that of the survivors, and the degree of fluid overload had a close association with the mortality. Conclusion Early and aggressive use of CVVH to control fluid overload in CRF patients with congestive heart failure can improve survival rate.
关键词
连续性静脉静脉血液滤过 /
慢性肾功能不全 /
充血性心力衰竭
Key words
Chronic renal failure /
Congestive heart failure
盛晓华 汪年松 简桂花 蒋月珍 唐令诠.
CVVH治疗慢性肾功能不全伴充血性心力衰竭患者的疗效观察[J]. 中国血液净化. 2005, 4(8): 440-442
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