持续低效血液透析治疗尿毒症合并心力衰竭患者临床研究.docVIP

持续低效血液透析治疗尿毒症合并心力衰竭患者临床研究 　　摘要：目的 研究持续缓慢低效血液透析（SLED）以及间断血液透析（IHD）对尿毒症合并心力衰竭患者的治疗效果。方法 纳入2010年6月～2016年9月，在我院住院的尿毒症合并心力衰竭患者63例，33例行SLED治疗，30例行IHD治疗，比较两组患者治疗前后的各项指标[包括心功能、平均动脉压（MAP）、左室射血分数（LVEF）、血肌酐以及尿素氮等]。结果 治疗后心功能改善的疗效情况：SLED组有效率为93.90%，IHD组有效率80.00%，差异有统计学意义（P0.05）。SLED组和IHD组患者治疗后Scr和BUN水平比治疗前均有显著下降（P0.01）；SLED组和IHD组患者MAP和LVEF水平比治疗前明显增加，差异有统计学意义（P0.05），且SLED治疗后的MAP和LVEF显著优于IHD组，差异有统计学意义（P0.05）。结论 对于毒症合并心力衰竭患者，SLED较IHD方案更加安全、有效。 　　关键词：持续缓慢低效血液透析；间断血液透析；尿毒症；心力衰竭。 　　中图分类号：R692 文献标识码：A 文章编号：1006-1959（2017）22-0042-02 　　Abstract：Objective To study the therapeutic effect of continuous slow and ineffective hemodialysis（SLED）and intermittent hemodialysis（IHD）in patients with uremia complicated with heart failure.Methods From June 2010 to September 2016，63 patients with uremia complicated with heart failure were enrolled in our hospital，33 patients underwent SLED treatment，30 patients underwent IHD treatment，the parameters of two groups were compared before and after treatment[including cardiac function，mean arterial pressure（MAP），left ventricular ejection fraction（LVEF），the effect of serum creatinine and blood urea nitrogen].Results The improvement of cardiac function after treatment：the effective rate of SLED group was 93.90%，and the effective rate was 80.00% in group IHD，the difference was statistically significant（P0.05）.SLED group and IHD group after treatment in patients with Scr and BUN levels than before treatment decreased significantly（P0.01）；SLED group and IHD group were MAP and LVEF levels were significantly increased than before treatment，the difference was statistically significant（P0.05），and SLED after the treatment of MAP and LVEF were significantly better than group IHD，there are statistically significant difference（P0.05）.Conclusion For patients with sepsis complicated with heart failure，SLED IHD scheme more secure and effective. 　　Key words：Sustained low efficiency hemodialysis；Intermittent hemodialysis；Uremia；Heart failure. 　　心力衰竭是尿毒?Y患者最危险的并发症，是其主要