連續性血液凈化與間歇性血液透析治療重癥急性腎衰竭的療效對比

顧雯

摘 要 目的：比較連續性血液凈化與間歇性血液透析治療重癥急性腎衰竭的療效。方法：收集2016年5月至2018年10月進行血液凈化治療的重癥急性腎衰竭患者60例，按照治療方案不同分為觀察組30例和對照組30例。觀察組接受連續性血液凈化治療，對照組接受間歇性血液透析治療，療程均為1～2周。比較兩組治療前后血流動力學指標、血肌酐（Scr）和血尿素氮（BUN）、病情（APACHEⅡ評分）和生活質量（SF-36表）變化情況。結果：觀察組患者治療后心率（HR）、Scr、BUN和APACHEⅡ評分均低于對照組，平均動脈壓（MAP）高于對照組，（P<0.05）。觀察組患者治療后精神健康、軀體疼痛、情感職能和生理功能評分均高于對照組（P<0.05）。結論：連續性血液凈化治療重癥急性腎衰竭療效優于間歇性血液透析，且對患者血流動力學影響小，對患者生活質量有明顯改善，可作為優選方案。

關鍵詞 重癥急性腎衰竭；連續性血液凈化；間歇性血液透析

中圖分類號：R459.5 文獻標志碼：A 文章編號：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

血液凈化技術是臨床治療腎衰竭的常用手段，在控制患者病情方面效果顯著，隨著該技術的不斷發展，其治療范圍已從腎衰竭的替代治療發展為重癥急性腎衰竭的支持治療，臨床應用前景廣闊[1]。連續性血液凈化和間歇性血液透析是血液凈化的兩種模式，目前臨床上對兩者的療效尚無統一結果[2-3]。本文對連續性血液凈化與間歇性血液透析治療重癥急性腎衰竭的優劣進行比較，以期為治療方案的選擇和優化提供參考。