连续性静脉-静脉血液滤过治疗慢性肾衰竭合并脑出血患者的效果

Efficacy of continuous veno-venous hemofiltration in treatment of chronic renal failure patients complicated with cerebral hemorrhage

  • 摘要:
      目的  探讨连续性静脉-静脉血液滤过(CVVH)对慢性肾衰竭(CRF)合并脑出血患者神经功能、肾功能及预后的影响。
      方法  回顾性分析CRF合并脑出血患者90例, 分为观察组与对照组,每组45例。观察组采用CVVH进行血液净化,对照组采用间歇性血液透析(IHD)进行血液净化。治疗前、治疗14 d后,采用美国国立卫生研究院卒中量表(NIHSS)、简易智力状态检查量表(MMSE)评价患者神经功能缺损及精神智力状态; 比较2组患者治疗前、治疗14 d后肾功能,血尿素氮(BUN)、血肌酐(Scr)指标; 比较2组并发症发生情况。
      结果  治疗14 d后, 2组患者NIHSS评分均降低且观察组低于对照组, MMSE评分均上升且观察组高于对照组,差异有统计学意义(P<0.05); 治疗14 d后, 2组患者BUN、Scr水平均下降且观察组各项水平均低于对照组,差异有统计学意义(P<0.05); 观察组急性心力衰竭发生率为15.56%(7/45), 低于对照组的37.78%(17/45), 观察组医院获得性肺炎发生率为24.44%(11/45), 低于对照组的44.44%(20/45), 差异均有统计学意义(P<0.05)。
      结论  CRF合并脑出血患者采取CVVH治疗方案效果理想,能够有效改善患者神经功能,促进肾功能恢复,降低并发症发生率。

     

    Abstract:
      Objective  To explore the effects of continuous veno-venous hemofiltration (CVVH) on neurological function, renal function and prognosis of chronic renal failure (CRF) patients complicated with cerebral hemorrhage.
      Methods  A total of 90 CRF patients complicated with cerebral hemorrhage were analyzed retrospectively, and they were divided into observation group and control group, with 45 cases in each group. The observation group was treated with CVVH for blood purification, and the control group was treated with intermittent hemodialysis (IHD) for blood purification. The National Institute of Health Stroke Scale (NIHSS) and Mini-mental State Examination (MMSE) were used to evaluate the neurological deficit status and mental intelligence status of the patients before treatment and 14 days after treatment; the renal function, blood urea nitrogen (BUN) and serum creatinine (Scr) were compared between the two groups before treatment and 14 days after treatment; the incidence of complications was compared between the two groups.
      Results  After 14 days of treatment, the NIHSS score decreased significantly and MMSE score increased significantly in both groups (P < 0.05), and the NIHSS score of the observation group was significantly lower than that of the control group (P < 0.05), while the MMSE score of the observation group was significantly higher than that of the control group (P < 0.05); after 14 days of treatment, the BUN and Scr levels decreased significantly in both groups, and the BUN and Scr levels of the observation group were significantly lower than those of the control group (P < 0.05); the incidence of acute heart failure was 15.56%(7/45) in the observation group, which was significantly lower than 37.78%(17/45) in the control group (P < 0.05); the incidence of hospital acquired pneumonia in the observation group was 24.44%(11/45), which was significantly lower than 44.44%(20/45) in the control group(P < 0.05).
      Conclusion  CVVH can effectively treat the CRF patients complicated with cerebral hemorrhage, which can effectively improve the neurological function of patients, promote the recovery of renal function and reduce the incidence of complications.

     

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