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目的:观察持续低效血液透析(SLED)抢救治疗肾功能不全并急性左心衰肺水肿的临床疗效。方法:28例患者均为常规间歇性透析(IHD)无法耐受者或IHD无法控制心衰者,而应用SLED治疗,采用Fresencics 4008s和Nuc-12型血液透析机,透析液为常规碳酸盐;透析液流量为300m1/min。F6或CA-HP130高通透析器,血流量为150～200m1/min,治疗时间为8～10小时,观察其血透疗效、临床症状、血BUN、Scr、HCO3一、K+、EF值等指标的变化。结果:SLED与IHD相比,临床症状得到明显好转,心功能明显改善。BUN、Scr治疗前后有显著的下降,EF值治疗后明显上升。结论:SLED与IHD相比具有相对缓慢及连续的特点,能有效地改善心、肾功能,可作为在无连续性肾脏替代治疗(CRRT)设备和技术条件下治疗肾功能不全并急性左心衰肺水肿的有效的替代治疗方法。
Objective: To observe the clinical efficacy of continuous inefficient hemodialysis (SLED) rescue treatment of renal insufficiency and acute left heart failure pulmonary edema. METHODS: Twenty-eight patients were all refractory to conventional intermittent dialysis (IHD) or were refractory to IHD and were treated with SLED using Fresencics 4008s and Nuc-12 hemodialysis machines. The dialysate was a conventional carbonate ; Dialysate flow of 300m1 / min. F6 or CA-HP130 high-pass dialyzer, blood flow of 150 ~ 200m1 / min, the treatment time is 8 to 10 hours, observe the hemodialysis effect, clinical symptoms, blood BUN, Scr, Variety. Results: Compared with IHD, SLED significantly improved clinical symptoms and improved cardiac function. BUN, Scr before and after treatment had a significant decline, EF value increased significantly after treatment. CONCLUSIONS: Compared with IHD, SLED has a relatively slow and continuous feature that can effectively improve heart and kidney function. It can be used as a treatment for renal insufficiency and acute left heart failure (CRRT) in equipment and techniques without continuous renal replacement therapy An effective alternative to pulmonary edema.