不同血液滤过器连续性血液滤过治疗尿毒症患者心包积液的对比观察

摘要

Objective To contrast the curative effect of different blood filter in the aspect of treating peri‐cardial effusion in uremia patients who uses the method of continuous hemofiltration.Methods Two hundred and three uremia patients with pericardial effusion were selected at random ,who once accepted continuous veno‐venous hemofiltration (CVVH) from Janurary 2009 to July 2014 .One hundred and one patients in the treatment group used AEF‐13 blood filter to do CVVH ,while 102 patients in control group used AEF‐10 to do it .The procedure is as follows :echocardiography is given to all of the 203 patients in both groups one day before doing CVVH ,one day after doing CVVH and four weeks after doing CVVH.The aim is to recheck and contrast the pericardial effu‐sion in left ventricular wall.Results ① The effective rate of the treatment after one day and that of after four weeks are 97 .0% and 95 .0% .Obviously ,they are higher than 93 .1% and 90 .2% ,which are the effective rate of control group .Differences are statistically significant (χ2 = 9 .119 ,P< 0 .05 ;χ2 = 8 .983 ,P<0 .05) .② On the day after treatment ,and four weeks after treatment ,the measurement of pericardial effusion in left ventricular wall are (8 ± 3)mm and(10 ± 3)mm ,lower than the results of control group which are (9 ± 5)mm and (11 ± 4) mm .Differences are statistically significant ( t= 2 .054 ,P< 0 .05 ;t= 3 .531 ,P<0 .05) .The measurement of peri‐cardial effusion is remarkably improved( P<0 .05) .For these two blood filters ,the contrastive data of one day af‐ter treatment and four weeks after treatment are statistically significant .Conclusion In contrast ,AEF‐13 is effec‐tive than AEF‐10 in the aspect of relieving the clinical symptoms of uremia patients with pericardial effusion and of reducing the effusion measurement.%目的：探讨连续性血液滤过（CVVH）不同血液滤过器治疗尿毒症患者心包积液的疗效对比。方法选取2009年1月至2014年7月接受CVVH治疗的尿毒症伴心包积液患者203例，治疗组101例，进行CVVH采用AEF‐13血液滤过器的疗法。对照组102例进行CVVH采用AEF‐10血液滤过器的疗法，超声心动图分别检测2组治疗前、治疗后1d、治疗后4周左心室后壁心包积液量，进行比较。结果①治疗组治疗后1d与治疗后4周有效率分别为97.0％、95．0％，明显高于对照组的93.1％、90.2％，差异有统计学意义（χ2＝9.119，P＜0.05；χ2＝8.983，P＜0.05）；②治疗组治疗后1d与治疗后4周心包积液超声心动图左心室后壁心包积液量分别为（8±3）mm、（10±3）mm，低于对照组的（9±5）mm、（11±4）mm，差异有统计学意义（t＝2.054，P＜0.05；t＝3.531，P＜0.05）。CVVH治疗后1d、治疗后4周心包积液量较治疗前均有显著改善（P＜0.05），2种不同血液滤过器血液净化方法治疗后1d、治疗后4周相比，差异均有统计学意义。结论CVVH疗法选择AEF‐13血液滤过器，对缓解尿毒症并发心包积液患者的临床症状，减少心包积液量较采用AEF‐10血液滤过器更为有效。