血液透析对尿毒症并发急性心力衰竭治疗作用探究.docVIP

血液透析对尿毒症并发急性心力衰竭治疗作用探究【摘要】目的：探讨血液透析（HD）治疗尿毒症并发急性心力衰竭的临床疗效。方法：血液透析治疗尿毒症并发心力衰竭患者78例，观察其血透前后各项临床和生化指标的变化情况。结果：78例患者血液透析前后体重、尿素氮、血肌酐、二氧化碳结合力、血钾水平等生化指标变化对比差异均有显著性（P0.001）；反映心功能的各项临床指标（如心率、平均动脉压、呼吸频率）明显改善（P0.001）；临床症状明显缓解，心功能改善2级以上68例(87.18％)；心功能改善1级以上8例(10.26％)；心功能无明显改善2例(2.56％)。心力衰竭改善的总有效率达97.44％。结论：血液透析对尿毒症并发心力衰竭患者的心功能改善有良好的治疗效果。 【关键词】心力衰竭；尿毒症；血液透析；心功能 文章编号：1009-5519（2007）11-1604-02 中图分类号：R5 文献标识码：A Research of therapeutic effect of hematodialysis in uremia complicated with acute heart failure LANG Xue-cong,ZHANG Liang,XIAO Ping-ping,et al. (Department of Nephrology,The Second People’s Hospital of Yibin,Sichuan 644000,China) 【Abstract】Objective:To explore the therapeutic effect of hemodialysis(HD) in the treatment of uremia complicated with acute heart failure.Methods:78 cases of uremia complicated with acute heart failure were treated by hemodialysis,and the changes of clinical and biochemical indices were observed before and after hemodialysis.Results:There were significant differenes in the body weight,urea nitrogen and the serum creatinine，CO2CP and potassium in all 78 cases before and after hemodialysis(P0.001).The clinical indices of heart functions such as heart rate,the average arterial pressure and breathing frequency improved significantly(P0.001).The clinical symptoms relieved obviously,the improvement of heart function was 2 levels or more in 68 cases(87.18%),1 level or more in 8 case(10.26%) and no improvement in 2 cases(2.56%).The total effective rate of the improvement of acute heart failure was 97.44%.Conclusion:Hemodialysis could effectively improve the heart function of uremia complicated with acute heart failure. 【Key words】Heart failure；Uremia；Hematodialysis；Heart function 我院从2000年1月～2005年12月对尿毒症并发心力衰竭患者78例，采用血液透析(HD)治疗，获得了较好的疗效，现将治疗效果报道如下。 1 资料与方法 1.1 病例选择：本组78例，其中男46例，女32例。年龄27～68岁。均符合急、慢性肾衰竭尿毒症的诊断[1]。本组患者出现心悸、端坐呼吸、口唇发绀、大汗淋漓、咳白色或粉红色泡沫痰、心率 98～142次/分、呼吸频率 28～42次/分、Bp 156～224/96～130 mmHg、出现舒张期奔马律、两肺底有湿?音和哮鸣音，心功能NYHA分级均为Ⅲ