10例地震伤挤压综合征致急性肾功能衰竭患者早期连续血液净化的疗效
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摘要
目的:观察地震伤挤压综合征致急性肾功能衰竭患者早期连续血液净化的疗效。方法:10例地震伤后挤压综合征致肾功能急性衰竭的患者早期采用连续血液净化疗法(CRRT),测定治疗前后血白细胞计数、血钾、尿素氮、血肌酐、肌酸激酶、肌红蛋白。结果:10例患者经CRRT治疗血白细胞计数、BUN、SCr、CK、MYO、高血钾、代谢性酸中毒等均较治疗前显著降低。结论:尽早行CRRT治疗地震伤后挤压综合征致急性肾功能衰竭,不但可迅速纠正患者内环境的紊乱,恢复肾功能,还可减轻全身炎性反应,缩短病程,改善预后,提高救治成功率。
Objective:To observe the efficacy of early continuous blood purification on the acute renal failure (ARF) patients induced by earthquake injuries crush syndrome. Methods: 10 cases of ARF patients caused by the earthquake injury crush syndrome,who were admitted to hospital with white blood cell >12×109/L in 10 cases,serum potassium>6 mmol/L in 10 cases,BUN> 10 mmol/L in 8 cases,SCr>200μmol/L in 10 cases,CK> 2million U/L in 9 cases,and MYO>90 mg/L in 10 cases,were treated with continuous renal replacement therapy (CRRT) in early period of ARF,and after treatment,the above mentioned indices were measured.Results:As compared with before treatment,the white blood cell count,level of BUN,SCr,CK,MYO,hyperkalemia,and metabolic acidosis in all patients were significant lower after treatment with CRRT. Conclusions: The ARF caused by earthquake injuries crush syndrome can be quickly and better improved with CRRT and restoration of renal function if application of CRRT is as early as possible for treatment of ARF. Furthermore,CRRT can reduce the systemic inflammatory response and short course of disease,improving the prognosis and the successful rate of therapy.
Objective:To observe the efficacy of early continuous blood purification on the acute renal failure (ARF) patients induced by earthquake injuries crush syndrome. Methods: 10 cases of ARF patients caused by the earthquake injury crush syndrome,who were admitted to hospital with white blood cell >12×109/L in 10 cases,serum potassium>6 mmol/L in 10 cases,BUN> 10 mmol/L in 8 cases,SCr>200μmol/L in 10 cases,CK> 2million U/L in 9 cases,and MYO>90 mg/L in 10 cases,were treated with continuous renal replacement therapy (CRRT) in early period of ARF,and after treatment,the above mentioned indices were measured.Results:As compared with before treatment,the white blood cell count,level of BUN,SCr,CK,MYO,hyperkalemia,and metabolic acidosis in all patients were significant lower after treatment with CRRT. Conclusions: The ARF caused by earthquake injuries crush syndrome can be quickly and better improved with CRRT and restoration of renal function if application of CRRT is as early as possible for treatment of ARF. Furthermore,CRRT can reduce the systemic inflammatory response and short course of disease,improving the prognosis and the successful rate of therapy.
引文
1Vanholder R,Sever MS,Erek E,et al.Acute renal failure related to the crush syndrome:towards an era of seismo-nephrology-Nephrol Dial Transplant,2000,15:1517~1521.
2Nicolau D,Feng YS,Wu AH,et al.Myoglobin clearance during continuous veno-venous hemofiltration with or with-out dialysis.Int J Artif Organs,1998,21:205~209.
3Vanholder R,Sever MS,Erek E,et al.Rhabdomyolysis.J Am Soc Nephrol,2000,11:1553~1561.
4徐玉芝,祝维秋,潘童,等.无肝素透析100例护理体会.山东医药,2007,47:119.
5唐琦,张黎明,邬碧波,等.局部枸橼酸体外抗凝、低分子量肝素和无肝素抗凝对高危出血倾向患者行血液透析的疗效和安全性.上海医学,2007,30:898~901.
6Nadjafi I,Atef MR,Broumand B,et al.Suggested guide-lines for treatment of acute renal failure in earthquake vic-tims.Ren Fail,1997,19:655~664.
2Nicolau D,Feng YS,Wu AH,et al.Myoglobin clearance during continuous veno-venous hemofiltration with or with-out dialysis.Int J Artif Organs,1998,21:205~209.
3Vanholder R,Sever MS,Erek E,et al.Rhabdomyolysis.J Am Soc Nephrol,2000,11:1553~1561.
4徐玉芝,祝维秋,潘童,等.无肝素透析100例护理体会.山东医药,2007,47:119.
5唐琦,张黎明,邬碧波,等.局部枸橼酸体外抗凝、低分子量肝素和无肝素抗凝对高危出血倾向患者行血液透析的疗效和安全性.上海医学,2007,30:898~901.
6Nadjafi I,Atef MR,Broumand B,et al.Suggested guide-lines for treatment of acute renal failure in earthquake vic-tims.Ren Fail,1997,19:655~664.
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