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目的:分析高龄急性肾衰患者血液净化效果,探讨其治疗的特殊性。方法:回顾性分析在我院诊治并进行血液净化的急性肾衰高龄患者资料共22例,其中1个器官衰竭1例,2个器官衰竭11例,3个器官衰竭6例,4个器官衰竭2例,5个器官衰竭2例。进行血液透析(HD)治疗15例,连续性静脉-静脉血液滤过(CVVH)治疗7例。结果:22例高龄ARF患者均经积极治疗原发病、抗感染、输血、补液、控制血压等对症治疗,存活16例,死亡6例,进行HD治疗共215次,死亡4例,进行CVVH治疗共41次,死亡2例。死亡病例包括4和5个器官衰竭患者4例,3个器官衰竭者1例和2个器官衰竭者1例。结论:高龄ARF患者病情变化较快和复杂,早期积极治疗并根据病情需要选择不同的血液净化疗法可减少合并症。一旦发现高龄ARF患者,应立即采取血液净化治疗。连续性肾脏替代治疗(CRRT)由于血流动力学稳定,对高龄合并多器官功能衰竭者比一般血透治疗更具优越性。
Objective: To analyze the blood purification effect of acute renal failure in elderly patients and explore its particularity. Methods: A total of 22 elderly patients with acute renal failure diagnosed and treated in our hospital were retrospectively analyzed. Among them, 1 case of organ failure, 11 cases of 2 organ failure, 6 cases of 3 organ failure and 4 organs failure 2 cases, 5 organ failure in 2 cases. Hemodialysis (HD) treatment in 15 cases, continuous venovenous hemofiltration (CVVH) treatment in 7 cases. Results: Twenty-two elderly patients with ARF were treated with active disease, anti-infection, blood transfusion, rehydration, blood pressure control and other symptomatic treatment. Survival was 16 and death was 6. A total of 215 HD patients were treated and 4 died. CVVH A total of 41 times, 2 deaths. The deaths included 4 patients with 4 and 5 organ failure, 1 patient with 3 organ failure, and 1 patient with 2 organ failure. CONCLUSIONS: The changes of ARF in elderly patients change rapidly and complicatedly. Early active treatment and different blood purification therapy can reduce the complication according to the needs of disease. Once found in patients with advanced ARF, blood purification should be taken immediately. Continuous renal replacement therapy (CRRT) due to hemodynamically stable, multi-organ failure in elderly patients with more than the general hemodialysis treatment more advantages.