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目的探讨连续性肾脏替代治疗与间歇性血液透析治疗重症急性肾功能衰竭的临床效果。方法选取2014年8月至2015年12月符合诊断标准的重症急性肾功能衰竭患者116例,根据治疗方法分为两组,观察组57例行连续性肾脏替代疗法,对照组59例给予间歇性血液透析治疗。比较两组血清指标及治疗12个月后存活率。结果治疗12个月后,两组患者血清尿素氮、血清肌酐、肌酐清除率水平均低于治疗前(P>0.05),且治疗后观察组血清尿素氮低于对照组,肌酐清除率下降幅度小于对照组(P<0.05)。观察组存活率为87.7%(50/57),对照组存活率为50.8%(30/59),两组比较差异有统计学意义(χ~2=5.582,P<0.05)。结论连续性肾脏替代治疗可有效改善患者血清尿素氮与血清肌酐水平、肌酐清除率的下降幅度,提高1年后存活率,改善远期预后,但其不能完全替代间歇性血液透析治疗。
Objective To investigate the clinical effects of continuous renal replacement therapy and intermittent hemodialysis on severe acute renal failure. Methods A total of 116 patients with severe acute renal failure who met the diagnostic criteria from August 2014 to December 2015 were divided into two groups according to the treatment method. The observation group received 57 consecutive renal replacement therapy and the control group, 59 patients were given intermittent Hemodialysis treatment. Serum parameters were compared between two groups and survival rate after 12 months of treatment. Results After 12 months treatment, the levels of serum urea nitrogen, serum creatinine and creatinine were lower in both groups than before treatment (P> 0.05). After treatment, serum urea nitrogen in the observation group was lower than that in the control group, and the rate of creatinine clearance Less than the control group (P <0.05). The survival rate of the observation group was 87.7% (50/57) and that of the control group was 50.8% (30/59). The difference between the two groups was statistically significant (χ ~ 2 = 5.582, P <0.05). Conclusion Continuous renal replacement therapy can effectively improve the serum urea nitrogen and serum creatinine levels, the decline of creatinine clearance rate, improve the survival rate after 1 year and improve the long-term prognosis, but it can not completely replace the intermittent hemodialysis treatment.