Objective To explore the clinical effect of continuous renal replacement therapy (CRRT) com-bined with BiPAP noninvasive ventilation on refractory end-stage heart failure. Methods Three hundred patients cas-es with refractory end-stage heart failure were divided into two groups according to different treatment in our hospital. All of them were given standard drug. In control group, 143 patients were given BiPAP, while in research group, 157 patients were given CRRT combined with BiPAP. The vital signs, NT-pro-BNP, LVEF, CRE, PaO2 and effect were ob-served and compared before and after treatment in the two groups. Results Compared to before treatment, the values of NT-pro-BNP after treatment significantly decreased in both control group and research group [(1 996 ± 63.7) pg/ml vs (875±29.4) pg/ml, (2 096±62.8) pg/ml vs (565±30.0) pg/ml, respectively, P<0.01]. The effect was better in research group. After treatment, the PaO2 in both groups were statistically significantlyincreased than those before treatment [(87.5 ± 2.94) mmHg vs (69.96 ± 6.37) mmHg, (92.5 ± 3.00) mmHg vs (68.86 ± 6.28) mmHg, respectively, P<0.01]. After treatment, the CRE in both groups were statistically significantly decreased than those before treatment [(199.6 ± 63.7) µmol/L vs (87.5 ± 2.94) µmol/L, (198.6 ± 62.8) µmol/L vs (76.5 ± 3.00) µmol/L, respectively, P<0.01). There was a statistically significant difference between the two groups (P<0.05). The effective rate of the change on drop-sy and exudation on rabat and heart doppler ultrasound, the effective rate on the dyspnea, heart function classification and mobility and the survival rate in the research group were statistically significantly higher than those in the control group (84.7%vs 71.3%, 82.8%vs 69.9%, 86.0%vs 76.9%, respectively, P<0.05). Conclusion CRRT combined with Bi-PAP noninvasive ventilation could effectively relieve the clinical symptoms, improve the heart function, increase the rate of escue success, which is a positive, safety and efficient treatment.%目的：探讨床旁血液滤过(CRRT)联合BiPAP无创机械通气治疗顽固性心力衰竭的临床治疗效果。方法根据治疗方法不同将我院300例顽固性心力衰竭患者分为两组，均给予标准药物治疗，对照组143例加用BiPAP无创机械通气治疗、研究组157例应用连续性CRRT联合BiPAP无创机械通气治疗，观察治疗前后两组患者的生命体征、NT-pro-BNP、左室射血分数、血肌酐、动脉氧分压等指标的变化和治疗效果。结果对照组治疗前后NT-pro-BNP值分别为(1996±63.7) pg/ml和(875±29.4) pg/ml，研究组分别为(2096±62.8) pg/ml、(565±30.0) pg/ml；两组患者治疗后NT-pro-BNP值均明显降低，与治疗前比较差异均有统计学意义(P<0.01)，研究组疗效更佳；对照组治疗前后血氧分压分别为(69.96±6.37) mmHg和(87.5±2.94) mmHg，研究组分别为(68.86±6.28) mmHg和(92.5±3.00) mmHg；两组患者治疗后血氧分压值均明显升高，与治疗前比较差异均有统计学意义(P<0.01)；研究组患者治疗后血氧分压值明显低于对照组，且两组间比较差异有统计学意义(P<0.01)；对照组治疗前后肌酐值分别为(199.6±63.7)µmol/L和(87.5±2.94)µmol/L，研究组分别为(198.6±62.8)µmol/L和(76.5±3.00)µmol/L，两组患者治疗后血肌酐值均明显降低，与治疗前比较差异均有统计学意义(P<0.01)；研究组患者治疗后血肌酐值明显低于对照组，且两组间比较差异有统计学意义(P<0.05)；研究组患者治疗后胸片渗出水肿改变及心脏彩超改变有效率为84.7%，对照组为71.3%，两组间比较差异有统计学意义(P<0.05)；研究组患者治疗后呼吸困难症状及心功能分级及活动能力有效率为82.8%，对照组为69.9%，两组间比较差异有统计学意义(P<0.05)；研究组患者生存率为86.0%，对照组为76.9%，两组患者生存率比较差异有统计学意义(P<0.05)。结论床旁血液滤过联合BiPAP无创机械通气治疗能有效缓解顽固性心力衰竭的临床症状，改善心功能，提高了抢救成功率，是一种积极、安全、有效地新型治疗方法。
展开▼
