连续性血液净化治疗顽固性心力衰竭临床疗效观察.docVIP

连续性血液净化治疗顽固性心力衰竭临床疗效观察[摘要] 目的:观察连续性血液净化对顽固性心力衰竭患者的临床疗效。方法:选择2008 年1 月～2009 年6月20例经药物治疗无效的心力衰竭患者,深静脉置管后应用连续性血液净化治疗。检测治疗前后血压、心率、呼吸频率、血氧饱和度、血离子、血气分析、血肌酐、血浆B型钠尿肽、左心室射血分数等指标的变化,并观察治疗效果。结果:应用连续性血液净化治疗后患者收缩压、舒张压下降,心率、呼吸减慢,血氧饱和度升高,血离子恢复正常,血pH值、血HCO3-、氧分压升高,血肌酐下降,血浆B型钠尿肽降低,左心室射血分数增加,患者临床症状减轻。结论:连续性血液净化能有效纠正顽固性心力衰竭患者水、电解质及酸碱失衡,明显改善心功能,是治疗顽固性心力衰竭的有效手段。 [关键词] 连续性血液净化;顽固性心力衰竭;临床疗效 [中图分类号] R541.61[文献标识码]A [文章编号]1673-7210(2010)01(b)-031-02 Clinical efficacy of continuous blood purification in the treatment of refractory heart failure GUO Yi’nan (The Fourth People’s Hospital of Shenyang City, Shenyang 110031, China) [Abstract] Objective: To study the effects of continuous blood purification (CBP) in the treatment of refractory heart failure. Methods: From January 2008 to June 2009, 20 patients with drug resistant heart failure were treated by continuous blood purification (CBP). Blood pressure, heart rate, respiratory rate, blood oxygen saturation, bloodion, blood gas analysis, blood serum, B-type natriuretic peptide (BNP), left ventricle ejection fraction (LVEF) were checked before and after treatment. Results: After application of continuous CBP for the patients, systolic blood pressure and diastolic blood pressure under decreased, heart rate and breathing slowed down, oxygen saturation, blood pH, plasma HCO3-, partial pressure of oxygen and left ventricle ejection fraction (LVEF) increased, blood plasma returned to normal, serum creatinine and B-type natriuretic peptide decreased. And the clinical manifestation was alleviated. Conclusion: CBP can efficiently treat the water-electrolyte disturbance, keep the acid-base balance and improve cardiac function. CBP is an effective method in treatment of refractory heart failure. [Key words] Continuous blood purification; Refractory heart failure; Clinical efficacy 顽固性心力衰竭(refractory heart failure,RHF)是指症状持续且对各种药物治疗反应较差的充血性心力衰竭,病死率高,临床处理非常棘手,也是长期困扰医学界的难题之一。连续性血液净化(continuous blood purification,CBP)是指所有连续缓慢清除水和溶质的