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目的:对比连续性血液净化(CBP)与间歇性血液透析(IHD)治疗重症急性肾衰竭(ARF)的临床疗效。方法:选择我院ICU于2014年1月~2016年12月间收治的32例重症ARF患者为研究对象,将17例接受CBP治疗者纳入观察组,15例接受IHD治疗者纳入对照组,比较两组患者治疗前后血流动力学指标及Scr、CRP及APACHEⅡ评分的变化,比较两组患者28d死亡率。结果:观察组患者上机后MAP及HR较治疗前无明显变化,对照组上机后MAP明显降低,HR明显升高,且与观察组比较差异有统计学意义;两组患者治疗后Scr、CRP及APACHEⅡ评分均较治疗前明显降低,观察组明显低于对照组,差异有统计学意义;两组患者28d死亡率比较差异无统计学意义。结论:CBP治疗重症急性肾衰竭,与IHD比较可以保持血流动力学稳定,有效促进患者肾功能的恢复、降低炎症反应并减轻疾病的严重程度。
Objective: To compare the clinical efficacy of continuous blood purification (CBP) and intermittent hemodialysis (IHD) in the treatment of severe acute renal failure (ARF). Methods: Thirty-two patients with severe ARF who underwent ICU in our hospital from January 2014 to December 2016 were enrolled in this study. Twenty-seven patients receiving CBP were enrolled in the observation group and 15 patients receiving IHD were included in the control group. The changes of hemodynamics, Scr, CRP and APACHEⅡ scores before and after treatment in both groups were compared, and the 28-day mortality was compared between the two groups. Results: MAP and HR in the observation group were not significantly changed after treatment, MAP in the control group was significantly lower than that in the control group, HR was significantly increased, and the difference was statistically significant compared with the observation group; two groups of patients after treatment Scr, CRP and APACHE Ⅱ scores were significantly lower than before treatment, the observation group was significantly lower than the control group, the difference was statistically significant; two groups of patients 28d mortality difference was not statistically significant. CONCLUSION: CBP treatment of severe acute renal failure, compared with IHD can maintain hemodynamic stability, effectively promote the recovery of renal function, reduce the inflammatory response and reduce the severity of the disease.