连续性血液透析治疗老年终末期心功能不全103例临床研究

摘要

Objective:To observe CRRT insuffi ciency of the old year-end-stage cardiac function of pa-tients .Methods :201 cases of the old year-end final heart function insufficiency were divided into CRRT group and the control group ,PiCCO monitored CO ,CI ,EVLWI ,HR to evaluate the hemodynamic evaluation of cardiac func-tion determination of plasma BNP ,records of mechanical ventilation parameters and ventilator support ,and arterial blood gas was measured to assess lung function situation .Results :Compared with the control group ,CRRT group blood flow dynamics CO (3 .47 ± 0 .14 vs 4 .59 ± 0 .37) ,CI (3 .45 ± 0 .24 vs 4 .68 ± 0 .75) ,EVLWI (7 .89 ± 0 .74 vs 5 .67 ± 0 .21) ,BNP (13283 .98 ± 173 .91 vs 4584 .26 ± 94 .71) ,ventilator support decreased arterial blood gas partial pressure of oxygen (85 .32 ± 14 .35 vs 101 .43 ± 5 .87)improved alveolar-arterial oxygen difference (15 .38 ± 3 .61 vs 7 .53 ± 3 .54) decreased ,heart and lung function improved .Conclusion:continuity hemodialysis can be effective in treating the old year-end final heart function insufficiency ,and slowly dehydrated to alleviate the burden on the heart ,and improve lung function .%目的：观察连续性肾脏替代治疗（CRRT ）对老年终末期心功能不全患者的疗效。方法：201例老年终末期心功能不全患者分血液透析组和对照组，脉搏指示连续心输出量监测（PiC-CO）心输出量（CO）、心指数（CI）、血管外肺水（EVLWI）、心率（HR）评估血流动力学，测定血浆脑型利钠肽（BNP）评估心功能，记录机械通气参数及呼吸机支持力度，测定动脉血气，评估肺功能情况。结果：与对照组相比，血液透析组血流动力学CO（3．47±0．14 vs 4．59±0．37）、CI（3．45±0．24 vs 4．68±0．75）、EVLWI（7．89±0．74 vs 5．67±0．21），BNP（13283．98±173．91 vs 4584．26±94．71），呼吸机支持力度明显下降，动脉血气氧分压（85．32±14．35 vs 101．43±5．87）提高，肺泡-动脉氧分压差（15．38±3．61 vs 7．53±3．54）下降，心肺功能改善。结论：缓慢、连续性血液透析可有效治疗老年终末期心功能不全，与缓慢脱水减轻心脏负担、改善肺功能等有关。