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目的 :观察连续性肾脏替代治疗对肾衰竭顽固性心衰的疗效。方法 :随机把 2 6例肾衰竭顽固性心衰患者分为连续性肾脏替代治疗 (CRRT)组和间歇性血液透析 (IHD)组 ,观察两组的疗效及治疗前后、治疗过程血生化变化情况。结果 :CRRT组治疗 3天总有效率 10 0 % ,IHD组治疗 1～ 3周总有效率 5 7.33% ,两组疗效比较差异非常显著 (P <0 .0 0 1)。治疗期间 CRRT组 BU N、Scr、co2 cp波动小 ,组内比较差异无显著性意义 (P>0 .0 5 ) ;而 IHD组波动大 ,透析日晨 BUN、Scr比非透析日高 (P<0 .0 1) ,co2 cp低于非透析日 (P<0 .0 5 )。IHD组每日晨 BU N、Scr高于 CRRT组 ,透析日晨尤明显 (P <0 .0 0 1)。结论 :CRRT是连续性治疗 ,能缓慢、等渗地清除水和溶质 ,较好地维持血流动力学的稳定性 ,对肾衰竭顽固性心衰的疗效显著
Objective: To observe the effect of continuous renal replacement therapy on refractory heart failure with renal failure. Methods: Twenty-six patients with refractory heart failure with renal failure were randomly divided into continuous renal replacement therapy (CRRT) group and intermittent hemodialysis (IHD) group. The curative effect and the changes of blood biochemistry before and after treatment were observed . Results: The CRRT group had a total effective rate of 10% after 3 days of treatment and a total effective rate of 7.33% after 1 to 3 weeks of treatment in IHD group. The difference between the two groups was significant (P <0.01). There was no significant difference in BU N, Scr and co2 cp between the CRRT group and the control group (P> 0.05), but the fluctuation of IHD group was higher than that of the non-dialysis day <0. 01), co2 cp was lower than non-dialysis day (P <0. 05). The daily BU N and Scr in IHD group were higher than those in CRRT group, especially on the day of dialysis (P <0.01). CONCLUSIONS: CRRT is a continuous treatment that can slowly and isotonic clear water and solute, maintain hemodynamic stability and have a significant effect on refractory heart failure with renal failure