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日间连续性静脉-静脉血液滤过治疗高龄老年急性肾衰竭伴多脏器衰竭46例回顾
http://www.100md.com 《中华现代内科学杂志》 2007年第1期
连续性静脉-静脉血液滤过;急性肾衰竭;老年人,,],连续性静脉-静脉血液滤过;急性肾衰竭;老年人,1资料与方法,2结果,3讨论,[参考文献]
     [摘要] 目的 观察日间连续性静脉-静脉血液滤过(CVVH)用于高龄老年重症急性肾功能衰竭(ARF)伴多器官功能衰竭(MOF)患者中的临床疗效以及治疗并发症的情况。方法 回顾性分析我院接受日间CVVH治疗的46例ARF患者的临床资料,年龄80~101(85.6±5.5)岁,观察CVVH的疗效及治疗过程中血压、心率等生命体征,监测治疗前后血尿素氮、肌酐、电解质、动脉血气变化,同时观察CVVH治疗中并发症情况。结果 所有患者对CVVH治疗均耐受良好,治疗过程中血压、心率平稳,血流动力学稳定。与治疗前相比较,血尿素氮、肌酐显著下降(P<0.05),电解质紊乱、酸中毒得到纠正。46例患者中存活时间超过2周者34例(73.9%),3例肾功能恢复正常。治疗中技术相关并发症发生率低,其中4例出现导管相关性感染,10例并发出血,经积极处理后好转。结论 高龄老年人应用日间CVVH救治ARF伴MOF是安全有效的,良好的内环境、稳定的血流动力学有助肾功能的恢复。CVVH并发症少,是救治高龄ARF的首选治疗手段。

    [关键词] 连续性静脉-静脉血液滤过;急性肾衰竭;老年人

    Daytime continuous venovenous hemofiltration treatment of acute renal failure complicated with multiple organ failure in 46 very elderly patients

    YAN Zhenwen,SUN Jianshe,YE Zhibin,et al.

    Department of Nephrology,Huadong Hospital,Shanghai 200040,China

    [Abstract] Objective To observe the efficacy of daytime continuous venovenous hemofiltration ( CVVH) in the treatment of elderly patients with severely acute renal failure.The complications during CVVH were also recorded.Methods The clinical data including blood pressure,heart rate,BUN,Scr,electrolyte,arterial blood gas of fortysix elderly patients aged 80~101 years ( average age was 85.6±5.5 years) with ARF and MOF treated with CVVH were analyzed.The complications were observed during CVVH. Results CVVH was well tolerated in all of the patients.During the period of treatment ......

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