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目的分析研究老年急性肾衰竭的原因,探索有效的血液净化方式。方法 89例老年急性肾衰竭的患者作为本研究的研究对象,回顾性分析年急性肾衰竭的病因,随机分为观察组45例和对照组44例。所有患者均采用左卡尼汀类药物进行治疗,对照组患者在此基础上采用血液透析过滤进行血液净化,观察组患者采用血液吸附的方法进行血液净化,比较两组患者治疗效果。结果 89例患者当中肾前性64例(71.91%)、肾性16例(17.98%)、肾后性9例(10.11%)。病因分析:感染45例(50.56%),血容量不足和心脑血管疾病等原因34例(38.20%);肾毒性药物、外伤手术、尿路梗阻等原因10例(11.24%)。治疗后,对照组患者的β2-微球蛋白水平为(18.5±3.3)mg/L,血清甲状旁腺激素水平为(165.3±35.2)ng/L;观察组患者的β2-微球蛋白水平为(11.3±2.5)mg/L,血清甲状旁腺激素水平为(147.5±38.4)ng/L,组间比较具有统计学意义(P<0.05)。结论临床上老年急性肾衰竭的主要病因是肾前性,患者采用卡尼汀类药物治疗配合采用血液吸附方法进行血液净化,可以有效的缓解患者的症状,降低不良反应的发生率,具有临床推广使用的价值。
Objective To analyze and study the causes of acute renal failure in the elderly and to explore effective ways of blood purification. Methods Eighty-nine elderly patients with acute renal failure were selected as the study subjects. The causes of acute renal failure were retrospectively analyzed. The patients were randomly divided into observation group (n = 45) and control group (n = 44). All patients were treated with levocarnitine. The patients in the control group were treated with hemodialysis for blood purification. The patients in the observation group were subjected to blood purification by blood adsorption. The therapeutic effect was compared between the two groups. Results Of the 89 patients, 64 (71.91%) were prerenal, 16 (17.98%) were renal, and 9 (10.11%) were posterior renal. Etiology analysis: infection in 45 cases (50.56%), hypovolemia and cardiovascular and cerebrovascular diseases in 34 cases (38.20%); nephrotoxic drugs, traumatic surgery, urinary tract obstruction in 10 cases (11.24%). After treatment, β2-microglobulin level in the control group was (18.5 ± 3.3) mg / L and serum parathyroid hormone level was (165.3 ± 35.2) ng / L; β2-microglobulin level in the observation group was (11.3 ± 2.5) mg / L and serum parathyroid hormone (147.5 ± 38.4) ng / L, respectively. There was significant difference between the two groups (P <0.05). Conclusions Clinically, the main cause of acute renal failure in elderly patients is prerenal. The patients were treated with carnitine and blood adsorption to purify the blood, which can effectively relieve the symptoms of patients and reduce the incidence of adverse reactions, with clinical promotion Use value.