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目的探讨连续性肾脏替代治疗(CRRT)对心脏术后急性肾损伤(AKI)患者的治疗效果。方法将心脏术后发生AKI且需行CRRT的17例患者分为存活组(A组)和死亡组(B组),记录围手术期、CRRT治疗前后的临床指标,分析肾功能和预后的关系。结果 17例AKI患者经CRRT治疗后死亡6例。与B组相比,A组术后距CRRT开始时间缩短(P<0.05),CRRT持续时间较长(P<0.01)。与治疗前相比,两组CRRT治疗后血清肌酐和尿素氮均下降(P<0.01和P<0.05),A组平均动脉压增加(P<0.01)。术前肾功能异常患者与正常患者的死亡比例无统计学差异(P>0.05)。结论 CRRT是心脏术后AKI的有效治疗手段,术后早期长时间CRRT能提高患者生存率。
Objective To investigate the effect of continuous renal replacement therapy (CRRT) on patients with acute renal injury (AKI) after cardiac surgery. Methods Seventeen patients with AKI who underwent CRRT after cardiac surgery were divided into survival group (A group) and death group (B group). The clinical indexes before and after perioperative period and CRRT treatment were recorded. The relationship between renal function and prognosis . Results Seventeen AKI patients died of CRRT after treatment. Compared with group B, the duration of CRRT in group A was shortened (P <0.05) and the duration of CRRT was longer (P <0.01). Compared with before treatment, serum creatinine and blood urea nitrogen decreased after CRRT treatment in both groups (P <0.01 and P <0.05), mean arterial pressure increased in group A (P <0.01). There was no significant difference in the proportion of deaths between preoperative renal dysfunction patients and normal patients (P> 0.05). Conclusion CRRT is an effective treatment for AKI after cardiac surgery. CRRT can prolong the survival of patients after a long period of time.