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目的观察CRRT(连续性肾脏替代治疗)治疗重症横纹肌溶解综合征合并急性肾衰竭的临床疗效。方法对2010～2012年抢救的16例重症横纹肌溶解综合征合并急性肾衰竭(ARF)患者进行CRRT治疗的临床资料进行回顾性分析。观察肌红蛋白、肌酸磷酸激酶、乳酸脱氢酶、肌酐、尿素氮、电解质以及生命体征变化。结果 16例患者经CRRT治疗后,肌红蛋白、肌酸磷酸激酶、乳酸脱氢酶、肌酐、尿素氮均显著下降,差异有统计学意义(P<0.05)。15例患者肾功能逐渐恢复正常,治愈出院,1例患者因病情延误死于多器官功能衰竭(MODS)。结论对于重症横纹肌溶解综合征合并急性肾衰竭应尽早进行CRRT治疗,从而改善患者的预后。
Objective To observe the clinical effect of CRRT (continuous renal replacement therapy) in the treatment of severe rhabdomyolysis syndrome complicated with acute renal failure. Methods The clinical data of 16 CRRT patients with severe rhabdomyolysis complicated with acute renal failure (ARF) who were rescued from 2010 to 2012 were analyzed retrospectively. Myoglobin, creatine phosphokinase, lactate dehydrogenase, creatinine, urea nitrogen, electrolytes, and changes in vital signs were observed. Results The myoglobin, creatine phosphokinase, lactate dehydrogenase, creatinine and urea nitrogen in 16 patients were significantly decreased after CRRT treatment, the difference was statistically significant (P <0.05). Fifteen patients returned to normal renal function and were cured and discharged. One patient died of multiple organ failure (MODS) due to delayed illness. Conclusion Severe rhabdomyolysis should be treated with CRRT as soon as possible in order to improve the prognosis of patients with acute renal failure.