【摘要】 目的探讨连续性肾脏替代治疗（continuous renal replacement therapy,CRRT）对急性肾衰竭合并心力衰竭患者的临床疗效。方法选取2014年5月至2017年5月北京博爱医院收治的82例急性肾衰竭合并心力衰竭患者为研究对象,根据患者所用的血液净化治疗方案将其分为CRRT组（45例）和间歇性血液透析（intermittent hemodialysis,IHD）组（37例）。对比两组患者治疗前后的肾功能指标[血尿素氮（blood urea nitrogen,BUN）、血清肌酐（serum creatinine,Scr）]、心功能指标[左心室射血分数（left ventricular ejection fraction,LVEF）、心输出量（cardiac output,CO）、每搏输出量（stroke volume,SV）]、血气分析指标[动脉血氧饱和度（arterial oxygen saturation,SaO₂）、动脉血氧分压（partial pressure of oxygen,PaO₂）]、平均动脉压（mean arterial pressure,MAP）、心率（heart rate,HR）、呼吸频率（respiratory rate,RR）、电解质指标（Na⁺、K⁺）、变化情况。结果治疗前,两组患者BUN、Scr、Na⁺、K⁺水平、LVEF、CO、SV、SaO₂、PaO₂、MAP、HR、RR比较均无显著差异（P_均>0.05）。治疗后,CRRT组患者BUN、Scr、Na⁺、K⁺水平及HR、RR、MAP均显著低于IHD组（P_均<0.05）,SV、LVEF、CO、PaO₂、SaO₂均显著高于IHD组（P_均<0.05）。结论 CRRT能够有效改善急性肾衰竭合并心力衰竭患者的肾功能与心功能,并维持患者血流动力学稳定和水电解质平衡。更多还原

【Abstract】 Objective To explore the clinical efficacy of continuous renal replacement therapy（CRRT）in patients with acute renal failure complicated with heart failure.Method 82 patients with acute renal failure complicated with heart failure admitted to Beijing Bo’ai Hospital from May 2014 to May 2017 were selected as the study subjects,they were divided into CRRT group（45 cases）and intermittent hemodialysis（IHD）group（37 cases）according to the blood purification treatment regimen.The renal function index[blood urea nitrogen（BUN）,serum creatinine（Scr）],left ventricular ejection fraction（LVEF）,cardiac output（CO）,stroke volume（SV）],blood gas analysis indicators[arterial oxygen saturation（SaO₂）,partial pressure of oxygen（PaO₂）],mean arterial pressure（MAP）,heart rate（HR）,respiratory rate（RR）,electrolyte indicators（Na⁺,K⁺）changes were compared between the two groups.Result Before treatment,there were no significant differences in BUN,Scr,Na⁺,K⁺levels and LVEF,CO,SV,SaO₂,PaO₂,MAP,HR,RR between the two groups(P_all>0.05).After treatment,the levels of BUN,Scr,Na⁺,K⁺HR,RR and MAP in CRRT group were significantly lower than those in IHD group(P_all<0.05),and SV,LVEF,CO,PaO₂,SaO₂ were significantly higher than those in IHD group(P_all<0.05).Conclusion CRRT can effectively improve renal function and cardiac function in patients with acute renal failure and heart failure,and maintain hemodynamic stability and water electrolyte balance.更多还原