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1、连续性血液净化治疗重症心力衰竭合并肾衰竭患者的疗效分析?26O?史里速Q生旦箜!鲞笙塑i望塑旦rification,May12,2008,Vo1.7,No.5●连续性血液净化治疗重症心力衰竭合并肾衰竭患者的疗效分析温德良刘卫江古英明谢长江张振辉?罗辉遏熊旭明【摘要】目的探讨应用连续性血液净化(CBP)治疗重症心力衰竭合并肾衰竭的价值.方法选择广州医学院第二附属医院危重病科2003年6月~2007年9月应用CBP治疗的19例重症心力衰竭合并肾衰竭患者资料进行回顾性分析.观察患者治疗前后血生化,动脉血气分析,血压,呼吸频率,心率,氧合指数和左心室射血分数
2、的改变.治疗前后记录BostOIq心力衰竭积分,APACHEⅡ评分.结果14例患者心功能明显改善,有效率73.7%:CBP治疗后患者血肌酐,血尿素氮很快下降,内环境能维持在相对稳定的水平;氧合功能逐渐改善,BoStOIq心力衰竭积分和APACHEII评分明显降低;治疗过程生命征稳定,低血压和心律失常发生率低.结论CBP能平稳地清除水分和溶质并保持血流动力学的稳定,可以安全有效地应用于重症心力衰竭合并肾衰竭的治疗.【关键词】连续性血液净化;重症心力衰竭:肾功能衰竭中图分类号:R541,R692.5文献标识码:AClinicalefficacyofcon
3、tinuousbloodpurificationinthetreatmentofsevereheartfailurepatientswithrenalfailureWENDe—liangJ,LIUWei-jiangj,GUYing—ming2,XIEChang-jiangi.ZHANGZhen.huil,LUOHHi—yu,XIONGXu—ruing.DepartmentofCriticalCareMedicine,Hemodialysiscentre.SecondAffiliatedHospi—talofGuangzhonMedicalColleg
4、e,Guangzhou510260,China[Abstract]ObjecfiveToinvestigatethetherapeuticvalueofcontinuousbloodpurification(CBP)inthetreatmentofsevereheartfailurepatientswithrenalfailure.MethotisWeretrOspectivelVanalyzed19casesofsevereheartfailurecomplicatedwithrenalfailureandtreatedinourintensive
5、careunitduringtheperiodofJune.2003throughSept.,2007.Bloodpressure,heartrate,respirationrate,bloodbiochemistry,arterialbloodgas,oxygenicindex(PaO2/FiO2)andleftventricleejectionfraction(LVEF)weremonitoredbeforeandduringthetreatment.ScoreofBostoncriteriafordiagnosingheartfailurean
6、dAPACHEIIscorewererecorded.ResultsAfterCBP,heartfunctionweresignificantlyimprovedin14patientswithaneffectiverateof73.7%.Serumcreatinineandbloodureanitrogendecreasedquickly.andhomeostasiswasre—established.Theoxygenicindeximprovedgradually,andthescoreofBostoncriteriafordiagnosing
7、heartfailureandAPACHEIIscoredecreasedsignificantlyafterthetreatment.Theirvitalsignsstabilized,andhypotensionandarrhythmiawererarelyencounteredduringCBP.ConclusionsCBPmaintainsastablehemodynamicssituationduringcleaningexcesswaterandsolute.Therefore.CBPiSaneffectiveandsafemethodf
8、orthetreatmentofsevereheartfailurewithrenalfailure.【Ke
