连续肾脏替代治疗重症监护病房低心排综合征患者的作用.docVIP

精品论文 参考文献 连续肾脏替代治疗重症监护病房低心排综合征患者的作用 潘华良 [摘 要]目的：观察应用连续肾脏替代治疗用于重症监护病房低心排综合征患者的临床效果。方法：选取在我院重症监护病房的低心排综合征并急性肾损伤患者30例，对其进行应用连续肾脏替代治疗。对比患者治疗前与治疗后各项重要指标的变化以及患者最后的疾患转归状况。结果：经过连续肾脏替代治疗72h后患者的心率、心排血指数、左室射血分数、平均动脉压、肺毛细血管楔压、中心静脉压、氧合指数以及尿素氮、肌酐、血乳酸、均较治疗前显著改善，多巴胺用量较治疗前明显减少（Plt;0.05），但是脉搏血氧饱和度无显著变化（Pgt;0.05）。在疾病的转归上，死亡的患者为3例，其余27例患者顺利出院。结论：应用连续肾脏替代治疗用于重症监护病房低心排综合征患者的临床效果显著，能有效改善患者的循环和肾脏功能。 [关键词] 连续肾脏替代治疗 重症监护病房 低心排综合征 临床效果 DOI:10.3760/cma.j.issn.1672-7088.2014.15.16 作者单位：322200，浙江金华，浦江县人民医院 [作者简介]潘华良(1980—)，女，浙江省浦江人，主管护师，大学本科，研究方向：危重病学护理。 The Effect of Continuous Renal Replacement Therapy in Curing Patients with Low Cardiac Output Syndrome in the Intensive Care Unit Pan Hualiang Abstract: Objective To observe the clinical effect of continuous renal replacement therapy (CRRT) in curing patients with low cardiac output syndrome (LCOS) in the intensive care unit (ICU). Method 30 cases of LCOS patients with acute renal injury were given CRRT. The important index changes before and after the treatment and the disease development of the patients were compared. Result The cardiac rate, cardiac output index, :left ventricular ejection fraction, mean arterial pressure, pulmonary capillary wedge pressure, central venous pressure, oxygenation index and urea nitrogen, creatinine, and blood lactic acid level of the patient after 72h of the CRRT were significantly improved, with the amount of dopamine apparently reduced compared to that before the treatment (Plt;0.05). There is no significant change in pulse oxygen saturation （Pgt;0.05）. Among all the patients, 3 has died, and the rest 27 all got smooth discharge. Conclusion The effect of CRRT in curing patients with LCOS in the ICU is significant. It can effectively promote the circulating and renal function of the patients. Key words: continuous renal replacement therapy; intensive care unit; low cardiac output syndrome; clinical effect 自从上个世纪70年代Kramer将连续性血液净化用于急性肾功能衰竭治疗后，因为在很长一段时间内连续性血液净化仅用于该种疾患的治疗而被习惯性地称之为连续肾脏替代治疗[1-2]。近些年