血液净化技术联合应用抢救急性肾衰竭临床研究

    Different blood purification techniques combined in treatment of acute renal failure

    • 摘要: 目的: 探讨不同血液净化(BP)技术在抢救重症急性肾衰竭(ARF)治疗中的疗效。方法: 1999年7月~2002年9月用间歇性血液透析(IHD)、连续性静-静脉透析滤过(CVVHDF)、血浆置换(PE)联合应用抢救ARF25例,其中多器官功能衰竭11例。比较了3种方法对肌酐、尿素氮、胆红素清除、纠正电解质酸碱液体平衡的不同点。结果: 25例ARF病死6例,总病死率24.0%。对肌酐、尿素氮的清除IHD效果最好,CVVHDF次之,PE效果最差。而对胆红素的清除相反,PE效果最佳,CVVHDF和IHD较差。结论: IHD、CVVHDF、PE对肌酐、尿素氮、胆红素清除效果各有不同,重症ARF根据病情采取相应有效的血液净化方法,并联合应用可明显降低病死率。

       

      Abstract: Objective: To investigate the efficacy of different blood purification techniques on acute renal failure.Methods: Twenty-five patients with severe acute renal failure,11 of whom suffered from mutliple organ dysfuction syndrome,were treated by intermitten hemodialysis(IHD),continuous hemodiafiltration(CVVHDF) and plasma exchange(PE).The predialysis and postdialysis serum urea nitrogen,creatinine and bilirubin were measured.The results were analysed and compared.Results: The total mortality was 24.0%.IHD was more effective in eliminating serum urea nitrogen and creatinine than CVVHDF or PE,while PE had better effect in eliminating bilirubin than CVVHDF or IHD.Conclusions: The combined therapy of IHD,CVVHDF and PE may reduce mortality of acute renal failure.

       

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