血液透析与连续性血液净化透析治疗急性肾衰竭的疗效及对患者毒素清除率和肾功能指标的影响被引量：45

Efficacy of Hemodialysis and Continuous Blood Purification Dialysis on Acute Renal Failure and its Influence on Toxin Clearance Rate and Renal Function Indexes

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摘要目的:探讨间歇性血液透析(IHD)与连续性血液净化透析(CBP)治疗急性肾衰竭(ARF)的疗效及对患者毒素清除率和肾功能指标的影响。方法:96例ARF患者随机分为CBP组(接受CBP治疗,48例)和IHD组(接受IHD治疗,48例),比较两组血气指标、肾功能指标、毒素清除率、治疗恢复情况及并发症发生率。结果:两组治疗后心率、收缩压(SBP)、舒张压(DBP)显著降低(P<0.05),血氧饱和度(SpO 2)显著升高(P<0.05),组间比较无显著差异(P>0.05);两组治疗后尿素氮(BUN)、血肌酐(Scr)、血磷、血尿酸、β2-微球蛋白(β2-MG)水平均显著降低(P<0.05),但CBP组降低幅度大于IHD组(P<0.05);CBP组BUN、Scr、血磷、血尿酸、β2-MG清除率显著高于IHD组(P<0.05);CBP组治疗时间短于IHD组(P<0.05),两组治疗后急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分均显著降低,但CBP组降低幅度大于IHD组(P<0.05);CBP组并发症发生率显著低于IHD组(P<0.05)。结论:CBP能有效提高ARF患者的透析效果,提高毒素清除率,促进肾功能恢复,减少并发症。 Objective:To explore the efficacy of intermittent hemodialysis(IHD)and continuous blood purification dialysis(CBP)in the treatment of acute renal failure(ARF)and its influence on toxin clearance rate and renal function indexes.Methods:96 patients with ARF were randomly divided into CBP group(given CBP therapy,48 cases)and IHD group(given IHD therapy,48 cases).Blood gas indexes,renal function indexes,toxin clearance rate,treatment recovery and incidence rate of complications were compared between the two groups.Results:After treatment,the heart rate,systolic blood pressure(SBP)and diastolic blood pressure(DBP)were significantly deScreased in the two groups(P<0.05)while the blood oxygen saturation(SpO 2)was significantly inScreased(P<0.05),and there were no significant differences between the two groups(P>0.05).After treatment,the levels of urea nitrogen(BUN),Screatinine(Scr),blood phosphorus,blood uric acid andβ2-miScroglobulin(β2-MG)were significantly deScreased in the two groups(P<0.05),but the deScreases in CBP group were greater than those in IHD group(P<0.05).The clearance rates of BUN,Scr,blood phosphorus,blood uric acid andβ2-MG in CBP group were significantly higher than those in IHD group(P<0.05).The treatment time in CBP group was shorter than that in IHD group(P<0.05).The acute physiology and chronic health evaluation II(APACHE II)scores in the two groups were significantly deScreased after treatment,and the reduction in CBP group was greater than that in IHD group(P<0.05).The incidence rate of complications in CBP group was significantly lower than that in IHD group(P<0.05).Conclusion:CBP can effectively improve the dialysis effects of ARF patients,enhance the toxin clearance rate,promote the recovery of renal function and reduce complications.