持续低效血液透析治疗尿毒症合并心力衰竭患者的临床研究(1)
摘要：目的 研究持续缓慢低效血液透析(SLED)以及间断血液透析(IHD)对尿毒症合并心力衰竭患者的治疗效果。方法 纳入2010年6月～2016年9月，在我院住院的尿毒症合并心力衰竭患者63例，33例行SLED治疗，30例行IHD治疗，比较两组患者治疗前后的各项指标[包括心功能、平均动脉压(MAP)、左室射血分数(LVEF)、血肌酐以及尿素氮等]。结果 治疗后心功能改善的疗效情况：SLED组有效率为93.90%，IHD组有效率80.00%，差异有统计学意义(P<0.05)。SLED组和IHD组患者治疗后Scr和BUN水平比治疗前均有显著下降(P<0.01)；SLED组和IHD组患者MAP和LVEF水平比治疗前明显增加，差异有统计学意义(P<0.05)，且SLED治疗后的MAP和LVEF显著优于IHD组，差异有统计学意义(P<0.05)。结论 对于毒症合并心力衰竭患者，SLED较IHD方案更加安全、有效。
关键词：持续缓慢低效血液透析；间断血液透析；尿毒症；心力衰竭。
, 百拇医药
中图分类号：R692 文献标识码：A 文章编号：1006-1959(2017)22-0042-02
Abstract：Objective To study the therapeutic effect of continuous slow and ineffective hemodialysis(SLED)and intermittent hemodialysis(IHD)in patients with uremia complicated with heart failure.Methods From June 2010 to September 2016，63 patients with uremia complicated with heart failure were enrolled in our hospital，33 patients underwent SLED treatment，30 patients underwent IHD treatment，the parameters of two groups were compared before and after treatment[including cardiac function，mean arterial pressure(MAP)，left ventricular ejection fraction(LVEF)，the effect of serum creatinine and blood urea nitrogen].Results The improvement of cardiac function after treatment：the effective rate of SLED group was 93.90%，and the effective rate was 80.00% in group IHD，the difference was statistically significant(P<0.05).SLED group and IHD group after treatment in patients with Scr and BUN levels than before treatment decreased significantly(P<0.01)；SLED group and IHD group were MAP and LVEF levels were significantly increased than before treatment，the difference was statistically significant(P<0.05)，and SLED after the treatment of MAP and LVEF were significantly better than group IHD，there are statistically significant difference(P<0.05).Conclusion For patients with sepsis complicated with heart failure，SLED IHD scheme more secure and effective.
, 百拇医药
Key words：Sustained low efficiency hemodialysis；Intermittent hemodialysis；Uremia；Heart failure.
心力衰竭是尿毒癥患者最危险的并发症，是其主要的死亡原因[1-2]。目前，临床上主要治疗方法为血液透析，常见的透析方式有间断性血液透析(IDH)、连续性静脉-静脉血液滤过(CVVH)、持续缓慢低效血液透析(SLED)等[3]，由于CVVH费用较高，在基层医疗单位无法普及使用。本研究回顾性分析了2010年6月～2016年9月，我院采用SLED与IHD两种方式对63例尿毒症合并心力衰竭患者进行治疗的情况，报道如下。
1资料与方法
1.1一般资料
纳入2010年6月～2016年9月，在我院住院的尿毒症合并心力衰竭患者63例，采取抛掷硬币法分为SLED治疗组和IHD治疗组，SLED治疗组33例，男17 例，女16 例；年龄30～71 岁，平均年龄(51.05±14.96)岁。IHD治疗组30例，男16 例，女14 例；年龄29～69岁，平均年龄(51.16±14.72)岁。两组患者资料差异无统计学意义，具有可比性。纳入标准：所有患者均符合尿毒症的诊断标准[3]，按美国纽约心脏病学会标准分级，均为心功能Ⅳ级。排除标准：合并重症肺炎、呼吸衰竭等疾病。
1.2方法, http://www.100md.com(汪军)
关键词：持续缓慢低效血液透析；间断血液透析；尿毒症；心力衰竭。
, 百拇医药
中图分类号：R692 文献标识码：A 文章编号：1006-1959(2017)22-0042-02
Abstract：Objective To study the therapeutic effect of continuous slow and ineffective hemodialysis(SLED)and intermittent hemodialysis(IHD)in patients with uremia complicated with heart failure.Methods From June 2010 to September 2016，63 patients with uremia complicated with heart failure were enrolled in our hospital，33 patients underwent SLED treatment，30 patients underwent IHD treatment，the parameters of two groups were compared before and after treatment[including cardiac function，mean arterial pressure(MAP)，left ventricular ejection fraction(LVEF)，the effect of serum creatinine and blood urea nitrogen].Results The improvement of cardiac function after treatment：the effective rate of SLED group was 93.90%，and the effective rate was 80.00% in group IHD，the difference was statistically significant(P<0.05).SLED group and IHD group after treatment in patients with Scr and BUN levels than before treatment decreased significantly(P<0.01)；SLED group and IHD group were MAP and LVEF levels were significantly increased than before treatment，the difference was statistically significant(P<0.05)，and SLED after the treatment of MAP and LVEF were significantly better than group IHD，there are statistically significant difference(P<0.05).Conclusion For patients with sepsis complicated with heart failure，SLED IHD scheme more secure and effective.
, 百拇医药
Key words：Sustained low efficiency hemodialysis；Intermittent hemodialysis；Uremia；Heart failure.
心力衰竭是尿毒癥患者最危险的并发症，是其主要的死亡原因[1-2]。目前，临床上主要治疗方法为血液透析，常见的透析方式有间断性血液透析(IDH)、连续性静脉-静脉血液滤过(CVVH)、持续缓慢低效血液透析(SLED)等[3]，由于CVVH费用较高，在基层医疗单位无法普及使用。本研究回顾性分析了2010年6月～2016年9月，我院采用SLED与IHD两种方式对63例尿毒症合并心力衰竭患者进行治疗的情况，报道如下。
1资料与方法
1.1一般资料
纳入2010年6月～2016年9月，在我院住院的尿毒症合并心力衰竭患者63例，采取抛掷硬币法分为SLED治疗组和IHD治疗组，SLED治疗组33例，男17 例，女16 例；年龄30～71 岁，平均年龄(51.05±14.96)岁。IHD治疗组30例，男16 例，女14 例；年龄29～69岁，平均年龄(51.16±14.72)岁。两组患者资料差异无统计学意义，具有可比性。纳入标准：所有患者均符合尿毒症的诊断标准[3]，按美国纽约心脏病学会标准分级，均为心功能Ⅳ级。排除标准：合并重症肺炎、呼吸衰竭等疾病。
1.2方法, http://www.100md.com(汪军)
参见：首页 > 医疗版 > 疾病专题 > 心血管科 > 心力衰竭