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目的观察持续性肾脏替代治疗(CRRT)联合血浆置换(PE)救治危重患者的临床疗效,并与血液透析或血液透析滤过进行比较。方法 60例危重症患者根据治疗方式的不同分为观察组和对照组,观察生化指标及临床疗效。结果两组治疗后血清BUN、Cr、和K+均较治疗前降低(P均<0.01);观察组治疗后CIC、CK、ALT、AST、LDH和D-Di均较治疗前下降(P<0.01),且下降幅度与对照组有统计学差异(P<0.05);观察组显效率和总有效率高于对照组(P均<0.05)。结论通过CRRT持续恒定地清除中小分子毒素、纠正水电解质酸碱平衡紊乱,并对于危重患者联合PE治疗可清除大分子毒素,可为临床危重患者抢救提供更多的手段和措施。
Objective To observe the clinical efficacy of continuous renal replacement therapy (CRRT) combined with plasma exchange (PE) in the treatment of critically ill patients and compare with hemodialysis or hemodiafiltration. Methods Sixty critically ill patients were divided into observation group and control group according to different treatment methods. Biochemical indexes and clinical efficacy were observed. Results The serum levels of BUN, Cr and K + in the two groups after treatment were lower than those before treatment (all P <0.01). The levels of CIC, CK, ALT, AST, LDH and D-Di in the observation group decreased ), And there was a significant difference between the decrease rate and the control group (P <0.05). The effective rate and total effective rate in the observation group were higher than those in the control group (all P <0.05). Conclusions Continuous and constant removal of small and medium-sized toxins by CRRT can correct the disorder of acid-base balance of water and electrolyte, and can remove macromolecular toxins in combination with PE therapy in critically ill patients, which may provide more measures and measures for the rescue of critically ill patients.