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目的观察心肺复苏患者限制液体输入对肾功能的影响。方法将心脏骤停患者随机分为限制液体组(治疗组)和充足液体组(对照组),均按照2005年心肺复苏指南推荐的方法进行CPR。气管插管,呼吸机辅助呼吸,并采用肺保护通气策略。两组患者均严密监测心电、血压、经皮血氧饱和度和血气分析,动态观察血肌酐(Cr)、尿素氮(BUN)等生化指标。结果 100例患者存活超过24 h,治疗组52例,对照组48例。同对照组相比,治疗组复苏成功后各时间段患者氧合指数明显改善。研究过程中,治疗组患者速尿用量明显高于对照组,且复苏后72 h时血尿素氮水平有轻度增高趋势,但与对照组相比,各时间段BUN和Cr两组均差异无统计学意义。结论限制液体入量在改善肺功能的同时,未明显导致肾功能的恶化。
Objective To observe the effects of fluid restriction on renal function in patients with cardiopulmonary resuscitation. Methods Patients with cardiac arrest were randomly divided into restricted fluid group (treatment group) and adequate fluid group (control group), all of whom were CPR according to the recommended method of CPR 2005. Endotracheal intubation, ventilator assisted breathing, and lung protection ventilation strategy. Two groups of patients were closely monitoring ECG, blood pressure, percutaneous oxygen saturation and blood gas analysis, dynamic observation of serum creatinine (Cr), blood urea nitrogen (BUN) and other biochemical indicators. Results 100 patients survived more than 24 h, 52 cases in the treatment group and 48 cases in the control group. Compared with the control group, the oxygenation index of patients in each group after successful resuscitation was significantly improved. During the study, the dosage of furosemide in the treatment group was significantly higher than that of the control group, and the blood urea nitrogen level slightly increased at 72 h after resuscitation, but there was no significant difference between the two groups Statistical significance. Conclusions Limiting fluid intake did not significantly lead to worsening of renal function while improving pulmonary function.