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目的观察连续性血液净化治疗(CRRT)对心肺复苏术成功后合并急性肾功能损伤患者临床效果。方法采用CRRT的主要模式连续性静脉—静脉血液滤过(CVVH)治疗3例心肺复苏术成功后合并急性肾功能损伤患者,对病情、主要抢救措施和结果等临床资料进行回顾性分析。结果例1、例2患者分别经CRRT治疗298h和148h后,尿量逐渐开始恢复,转为隔日进行CRRT治疗,每天治疗6～8h,分别治疗6次和10次后转为普通血液透析滤过治疗,复查肾功能基本正常后停止血液净化治疗;第3例患者经CRRT连续治疗18h后,因血压呈持续下降趋势,达不到CRRT治疗所需要求,经抢救无效临床死亡。结论心肺复苏术成功后部分患者常合并急性肾功能损伤,尽早进行CRRT治疗,可使患者安全度过急性应激期,提高患者的生存率。
Objective To observe the clinical effect of continuous blood purification (CRRT) on patients with acute renal injury after successful cardiopulmonary resuscitation. Methods The primary CRRT model of continuous veno-venous hemofiltration (CVVH) was used to treat 3 patients with acute renal injury after cardiopulmonary resuscitation (CPR). The clinical data of the patients, major rescue measures and results were retrospectively analyzed. Results In patients with cases 1 and 2, the urine volume gradually began to recover after 298 hours and 148 hours of CRRT treatment, respectively. The patients were switched to CRRT every other day for 6 to 8 hours. After 6 and 10 times of treatment, they were switched to general hemodiafiltration Treatment, review of basic renal function after the normal blood purification treatment stopped; the third case of patients treated by continuous treatment of CRRT 18h, due to the continued downward trend in blood pressure, CRRT treatment fails to meet the requirements, after the rescue ineffective clinical death. Conclusions After successful CPR, some patients often suffer from acute renal injury. As soon as possible, CRRT treatment can make patients safely pass the acute stress phase and improve their survival rate.