紧急床旁血液滤过在尿毒症患者急性左心衰竭伴低氧血症应用.docVIP

紧急床旁血液滤过在尿毒症患者急性左心衰竭伴低氧血症应用 　　【摘要】 目的 探讨紧急床旁血液滤过治疗尿毒症患者急性左心衰竭伴低氧血症的临床疗效。方法 采用自身对照的方法， 对重症加强护理病房（ICU）中21例尿毒症发作急性左心衰竭伴有低氧血症的患者行紧急床旁血液滤过治疗， 观察治疗前后心率（HR）、呼吸频率（RR）、平均动脉压（MAP）、动脉血氧分压（PaO2）以及血清肌酐（Scr）、尿素氮（BUN）、钾离子（K+）、碳酸氢根离子（HCO3-）浓度的变化。结果 21例患者接受单次血液滤过后急性左心衰竭均有缓解， 与治疗前比较， MAP、HR、RR、PaO2均有改善， 差异均有统计学意义（P0.01）；BUN、Scr、K+浓度下降， HCO3-浓度升高， 差异均有统计学意义（P0.01）。结论 紧急床旁血液滤过治疗尿毒症患者急性左心衰竭伴低氧血症临床疗效显著。 　　【关键词】 紧急；床旁；血液滤过；尿毒症；急性左心衰竭；低氧血症 　　DOI：10.14163/j.cnki.11-5547/r.2016.11.005 　　Application of emergent bedside hemofiltration for acute left ventricular failure complicated with hyoxemia in uremia patients TAN Hua-qiao， HU Hao-rong， GAO Dong-ben， et al. Department of Intensive Medicine， Guangdong Dongguan City Changping Hospital， Dongguan 523573， China 　　【Abstract】 Objective To investigate clinical effect by emergent bedside hemofiltration for acute left ventricular failure complicated with hyoxemia in uremia patients. Methods Treatment by emergent bedside hemofiltration was given to 21 uremia patients with acute left ventricular failure complicated with hyoxemia in intensive care unit （ICU） by self-control method. Observation was made on chagnes of heart rate （HR）， respiratory rate （RR）， mean arterial pressure （MAP）， arterial partial pressure of oxygen （PaO2）， and concentration of serum creatinine （Scr）， blood urea nitrogen （BUN）， potassium （K+） and bicarbonate radical （HCO3-） before and after treatment. Results All the 21 patients had relieved acute left ventricular failure after single hemofiltration. Comparing with those before treatment， their had improved MAP， HR， RR and PaO2 after treatment， and their difference had statistical signficance （P0.01）. Their concentration of BUN， Scr and K+ decreased， and concentration of HCO3- increased， and the difference had statistical signficance （P0.01）. Conclusion Emergent bedside hemofiltration privdes precisely clinical effect for acute left ventricular failure complicated with hyoxemia in uremia patients. 　　【Key words】 Emergent； Beds