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选择DN混合性酸中毒患者22例,所有患者均接受常规基础治疗联合连续血液透析治疗,分别测量并记录患者治疗前及连续性肾脏替代治疗后12h、24h、48h生化指标以及酸中毒指标的变化,记录观察不良反应。结果治疗后患者有效血浆渗透压、血K+、BUN、SCr和Glu均呈显著下降趋势(P<0.05),与治疗前比较,治疗后24h有效血浆渗透压表现出显著差异(P<0.05),而治疗后12h血K+、BUN、SCr和Glu表现出显著差异(P<0.05),治疗前后血Na+变化比较差异无统计学意义;治疗后患者Lac呈显著下降趋势,PH、CO2CP呈显著上升趋势,差异有统计学意义(P<0.05),与治疗前比较,治疗后24h Lac、PH表现出显著差异(P<0.05),而治疗后12h CO2CP表现出显著差异(P<0.05);治疗过程中未出现严重并发症。结论连续血液透析治疗DN混合性酸中毒疗效满意,能迅速改善内环境,稳定血流动力学,减轻酸中毒,且安全性高。
Twenty-two patients with DN mixed acidosis were selected. All patients received routine basic therapy combined with continuous hemodialysis. The changes of biochemical indexes and acidosis indexes at 12 h, 24 h, 48 h after treatment and continuous renal replacement therapy were measured and recorded respectively , Record the adverse reactions observed. Results After treatment, the effective plasma osmolality, blood K +, BUN, SCr and Glu were significantly decreased (P <0.05), and the effective plasma osmolality at 24h after treatment showed significant difference (P <0.05) (P <0.05). There was no significant difference in blood Na + level before and after treatment between 12 and 12h after treatment. Lac after treatment showed a significant downward trend, and PH and CO2CP showed a significant upward trend (P <0.05). Compared with those before treatment, there was a significant difference in Lac and PH at 24 h after treatment (P <0.05), while CO2CP at 12 h after treatment showed significant difference (P <0.05) No serious complications occurred. Conclusion Continuous hemodialysis treatment of DN mixed acidosis with satisfactory results, can quickly improve the internal environment, stable hemodynamics, reduce acidosis, and high safety.