连续性血液净化与间歇性血液透析治疗重症急性肾衰竭的疗效对比

顾雯

摘 要 目的：比较连续性血液净化与间歇性血液透析治疗重症急性肾衰竭的疗效。方法：收集2016年5月至2018年10月进行血液净化治疗的重症急性肾衰竭患者60例，按照治疗方案不同分为观察组30例和对照组30例。观察组接受连续性血液净化治疗，对照组接受间歇性血液透析治疗，疗程均为1～2周。比较两组治疗前后血流动力学指标、血肌酐（Scr）和血尿素氮（BUN）、病情（APACHEⅡ评分）和生活质量（SF-36表）变化情况。结果：观察组患者治疗后心率（HR）、Scr、BUN和APACHEⅡ评分均低于对照组，平均动脉压（MAP）高于对照组，（P<0.05）。观察组患者治疗后精神健康、躯体疼痛、情感职能和生理功能评分均高于对照组（P<0.05）。结论：连续性血液净化治疗重症急性肾衰竭疗效优于间歇性血液透析，且对患者血流动力学影响小，对患者生活质量有明显改善，可作为优选方案。

关键词 重症急性肾衰竭；连续性血液净化；间歇性血液透析

中图分类号：R459.5 文献标志码：A 文章编号：1006-1533（2019）16-0028-03

Comparison of the efficacy of continuous blood purification and intermittent hemodialysis in the treatment of severe acute renal failure

GU Wen

（Intensive Care Unit of Xingang Central Hospital of Xinyu， Jiangxi Province 338000， China）

ABSTRACT Objective： To compare the efficacy of continuous blood purification and intermittent hemodialysis in the treatment of severe acute renal failure. Methods： Sixty patients with severe acute renal failure treated with blood purification from May 2016 to October 2018 were collected， and according to the different treatment options， divided into an observation group with 30 cases and a control group with 30 cases. The observation group received continuous blood purification treatment， the control group received intermittent hemodialysis， and the course of treatment was from 1 to 2 weeks. The changes of hemodynamic parameters， serum creatinine（Scr）， blood urea nitrogen（BUN）， condition（APACHE II score） and quality of life（SF-36 table） before and after treatment were compared between the two groups. Results： The heart rate（HR）， Scr， BUN and APACHE II scores in the observation group were lower than those in the control group after treatment， and the mean arterial pressure（MAP） in the observation group was higher than that in the control group（P<0.05）. The scores of mental health， physical pain， emotional function and physiological function of the patients in the observation group were higher than those in the control group after treatment（P<0.05）. Conclusion： Continuous blood purification is superior to intermittent hemodialysis in the treatment of severe acute renal failure， and has little effect on hemodynamics of patients and a significant improvement in the quality of life of patients， which can be used as a preferred solution.

KEY WORDS severe acute renal failure； continuous blood purification； intermittent hemodialysis

血液凈化技术是临床治疗肾衰竭的常用手段，在控制患者病情方面效果显著，随着该技术的不断发展，其治疗范围已从肾衰竭的替代治疗发展为重症急性肾衰竭的支持治疗，临床应用前景广阔[1]。连续性血液净化和间歇性血液透析是血液净化的两种模式，目前临床上对两者的疗效尚无统一结果[2-3]。本文对连续性血液净化与间歇性血液透析治疗重症急性肾衰竭的优劣进行比较，以期为治疗方案的选择和优化提供参考。