摘要
目的：对比性研究连续性肾替代及自动腹膜透析治疗心脏术后急性肾损伤的治疗效果。方法：筛选于2013年7月-2015年3月期间在海南省农垦总医院及海口市人民医院行心脏手术,术后并发急性肾损伤符合条件的患者80例,40例患者实施自动化腹膜透析,根据透析剂量分为150 ml ·kg-1· d-1（ A1组）20例和300 ml · kg-1· d-1（ A2组）20例,40例患者实施连续性肾替代疗法,根据透析剂量分为25 ml·kg-1·h-1（C1组）20例和40 ml·kg-1·h-1（C2组）20例,记录透析前、治疗（12 h、24 h、48 h、72 h）后,患者血BUN、Scr、钾离子（K＋）浓度,记录各组治疗效果及不良事件发生情况。结果：A1、A2、C1及C2组治疗后血 BUN、Scr及血 K＋各时间点均有不同程度的降低,其中在72 h 时降低显著（ P 〈0.01）；各组30 d存活率差异无统计学意义,A2组较A1组在肾功能完全恢复率、肾功能完全恢复所需时间、肾功能总恢复率及少尿缓解所需时间上差异均具有统计学意义（P〈0.05或P〈0.01）；C2组较C1组肾功能完全恢复所需时间及少尿缓解所需时间上差异均具有统计学意义（P〈0.05或P〈0.01）；C1较A1,C2较A2少尿缓解所需时间长,差异有统计学意义（P〈0.01）；A2较A1组、C2较C1组心动过速发生率高,C2组较C1组、A2组低血压发生率高,差异有统计学意义（P〈0.05）；在凝血发生率方面,各组差异无统计学意义。结论：两种方法治疗心脏术后急性肾损伤大剂量治疗效果较好,但不良事件发生率大剂量较高,APD在不良时间发生率及少尿缓解上优势明显。
Objective：To contrastive study of continuous renal replacement therapy and automated peritoneal dialysis on the treatment of acute kidney injury after cardiac surgery treatment. Methods：Screening 80 patients with acute kidney injury after cardiac surgery treatment in Hainan provincial general hospital and haikou hospital during 2013. 7-2015. 3, 40patients implementation of au-tomated peritoneal dialysis, 150 ml·kg-1·d-1（A1 group） 20 cases and 300ml·kg-1·d-1（A2 group） 20cases according to dial-ysis dose, 40cases with continuous renal replacement therapy, 25ml·kg-1 ·h-1 （ C1 group） 20 cases and 40ml·kg-1 ·h-1 （ C2 group） 20 cases according to the dialysis dose. Patients were recorded the serum BUN, Scr, K＋ concentration before and after dialy-sis treatment （12 h, 24 h, 48 h, 72 h）, the occurrence of adverse events in each treatment group. Results：Serum BUN, Scr and K＋were decreased in different degree in A1, A2, C1 and C2 group at different time point after treatment, and significantly reduced at 72 h （P〈0. 01）;difference of 30 d survival in each group was not statistically significant; differences were statistically significant between A2 group and A1 group in full recovery rate of renal function, time required for full recovery of renal function, renal function overall recovery rate and time required for oliguria ease （P〈0. 05 or P〈0. 01）;differences were statistically significant between C2 group and C1 group in time required for full recovery of renal function for oliguria ease （P〈0. 05 or P〈0. 01）;time required to alle-viate oliguria was longer in C1 than A1 group, C2 than A2 group and the difference was significant （P〈0. 01）;there was higher inci-dence of tachycardia in A2 than A1 group, C2 than C1 group, higher incidence of hypotension rate in C2 group than C1 and A2 group, the differences were statistically significant （P〈0. 05 ）;on the incidence of blood clotting, there was no statistically signifi-cant difference in each group. Conclu
出处
《中国中西医结合肾病杂志》
2015年第8期680-683,共4页
Chinese Journal of Integrated Traditional and Western Nephrology
基金
海南省自然科学基金资助项目(No.814342)
关键词
连续性肾替代
自动腹膜透析
急性肾损伤
Continuous renal replacement
Automated peritoneal dialysis
Acute kidney injury
