摘要
目的 探讨连续性血液透析（CBP）治疗糖尿病肾病酮症酸中毒（DKA）合并急性肾损伤患者的疗效及对血液动力学的影响。方法 回顾性分析2011年6月-2015年6月我院收治的DKA合并急性肾损伤患者102例,其中采用间歇性血液透析（IHD）治疗44例,CBP治疗58例。检测两组治疗前后空腹血糖（BFS）、血尿素氮（BUN）、血肌酐（SCr）、有效血浆渗透压（POP）、二氧化碳结合力（CO2CP）、血K＋、血Na＋、动脉p H值,评估治疗效果,并比较两组血液动力学指标变化。结果 治疗30 d后,两组BFS、POP、CO2CP、BUN、SCr、血K＋、动脉p H值水平较治疗前均有明显改善（P〈0.05）,且CBP组POP、CO2CP、BUN、SCr改善程度显著优于IHD组（P〈0.05）;两组CVP、CO、SVR、CI、TFC较治疗前均显著降低（P〈0.05）,且CBP组CVP、SVR、CI、TFC降低程度显著优于IHD组（P〈0.05）;CBP组的MAP、CVP、SVR恢复率显著高于IHD组（P〈0.05）,更趋于正常。结论 CBP可显著改善DKA合并急性肾损伤患者肾功能,使患者血液动力学指标趋于正常,值得临床推广应用。
Objective To explore the effects of continuous blood purification （CBP） in treatment of diabetic nephropathy（DN） diabetic ketoacidosis （DKA） complicated with acute kidney injury and on hemodynamics. Methods A total of 102 patients with DKA with acute renal injury and admitted to our hospital from June 2011 to June 2015 were retrospectively analyzed. Among them, 44 patients were treated with intermittent hemodialysis （IHD） and 58 patients were treated with CBP. The BFS, BUN, SCr, POP, CO2CP, K＋, Na＋ and arterial pH in the two groups were detected to evaluate the efficacy and compare the changes in hemodynamic indexes in the two groups. Results 30 days later since the treatment, the levels of BFS, POP, CO2CP, BUN, SCr, K＋ and arterial pH in the two groups were significantly improved when compared with those before the treatment （P 〈 0.05）, and the improvement of POP, CO2CP, BUN and SCr in the CBP group was significantly better than that in the IHD group （P 〈 0.05）; the CVP, CO, SVR, CI and TFC in the two groups were significantly lower than those before the treatment（P 〈 0.05）, and the reduction of CVP, SVR, CI and TFC in tbe CBP group was more significant than that in the IHD group （P 〈 0.05）; the recovery rate of MAP, CVP and SVR in the CBP group was significantly higher than that in the IHD group （P 〈 0.05）. Conclusion CBP can significantly improve the renal function of patients with DKA and acute kidney injury, make the hemodynamic indexes return to normal levels, and is worth of clinical popularization and application.
出处
《西南国防医药》
CAS
2016年第10期1115-1118,共4页
Medical Journal of National Defending Forces in Southwest China
