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目的 :观察连续性静脉静脉血液透析滤过 (CVVHDF)治疗慢性肾功能衰竭 (CRF)合并肝性脑病的效果。 方法 :12例CRF合并肝性脑病患者应用PrismaTM机器行CVVHDF治疗 ,置换液流速 80 0～ 12 0 0ml/h ,透析液流量 70 0～ 10 0 0ml/h ,共治疗 72～ 12 0h ,治疗前及治疗 72h后行Glasgow Pittsburgh评分及Pugh Child分级。 结果 :12例患者死亡 2例 ,存活 10例 ,其中 1例肾功能恶化需维持性透析 ;治疗后 11例患者清醒 ;治疗 72h后血清总胆红素、间接胆红素、尿素氮、肌酐、尿酸及血氨较治疗前显著降低 ,高钾血症及低钠血症均得以纠正 ,Glasgow Pitts burgh评分及Pugh Child分级构成比与治疗前相比有显著改善 ;治疗后 1例患者滤器Ⅰ级凝血。 结论 :CVVHDF可稳定清除毒素并维持血流动力学稳定 ,可用于CRF合并肝性脑病患者的治疗
Objective: To observe the effect of continuous intravenous venous hemodiafiltration (CVVHDF) on chronic renal failure (CRF) with hepatic encephalopathy. Methods: Twelve patients with CRF complicated with hepatic encephalopathy were treated with CVVHDF by PrismaTM machine. The flow rate of replacement fluid was 80 0 ~ 120 ml / h and the dialysate flow rate was 70 0 ~ 100 ml / h for 72 ~ 120 h. Before treatment The Glasgow Pittsburgh score and Pugh Child classification were obtained 72h after treatment. Results: Twelve patients died in 12 patients and survived in 10 patients, of which 1 patient required maintenance dialysis after deterioration of renal function. After treatment, 11 patients were awake; Total bilirubin, indirect bilirubin, urea nitrogen, creatinine, Uric acid and blood ammonia significantly lower than before treatment, hyperkalemia and hyponatremia were corrected, Glasgow Pitts burgh score and Pugh Child grading composition than before treatment significantly improved; after treatment, 1 patient’s filter grade Blood clotting. Conclusion: CVVHDF can remove toxins stably and maintain hemodynamic stability, which can be used in the treatment of CRF with hepatic encephalopathy