两种肾脏替代疗法治疗老年乳酸酸中毒患者的疗效比较

发布时间：2018-05-21 05:44

本文选题：乳酸酸中毒 + 肾脏替代疗法　；参考：《中国老年学杂志》2017年02期

【摘要】：目的对比持续静脉-静脉血液滤过(CVVH)以及持续静脉-静脉血液透析(CVVHD)两种肾脏替代治疗对老年患者乳酸酸中毒的改善效果。方法 180例老年乳酸酸中毒患者随机分为CVVH组和CVVHD组,每组90例。所有患者均实施常规基础治疗,CVVH组在常规治疗的基础上采用CVVHD,均进行24 h持续治疗。监测并对比两组患者治疗前与治疗后4、8、12、24、48 h的血液乳酸、血生化、凝血功能与动脉血气;对比两组患者的ICU住院时间和住院病死率。结果与治疗前比较两组患者治疗后的乳酸水平与p H均得以显著改善;但在治疗前与治疗后4、8、12、24、48 h,两组患者之间的乳酸水平与p H无统计学差异(P0.05)。两组患者的ICU住院时间〔(8.7±2.1 vs 9.0±2.6)d〕、住院病死率(11.1%vs.8.9%)差异无统计学意义(P0.05)。结论 CVVH与CVVHD均可以有效清除老年乳酸酸中毒患者的乳酸水平,改善酸碱失衡状态,ICU住院时间与住院病死率无显著差异。
[Abstract]:Objective to compare the effects of continuous veno-venous hemofiltration (CVVH) and continuous veno-venous hemodialysis (CVVHD) on lactic acidosis in elderly patients. Methods 180 elderly patients with lactic acidosis were randomly divided into CVVH group and CVVHD group with 90 cases in each group. All the patients were treated with CVVHD on the basis of routine treatment. The blood lactic acid, blood biochemistry, blood coagulation function and arterial blood gas were monitored and compared between the two groups before and after treatment, and the hospitalization time and mortality of ICU were compared between the two groups. Results the lactic acid level and pH of the two groups were significantly improved after treatment, but there was no significant difference in lactic acid level and pH between the two groups for 48 h before and after treatment (P 0.05). The hospitalization time of ICU was 8.7 卤2.1 vs 9.0 卤2.6 d, and the inpatient mortality was 11.1vs.8.9) there was no significant difference between the two groups (P 0.05). Conclusion both CVVH and CVVHD can effectively eliminate lactic acid level in elderly patients with lactic acidosis. There is no significant difference in hospital stay and mortality between CVVH and CVVHD in improving acid-base imbalance.
【作者单位】：琼海市人民医院重症医学科;
【分类号】：R459.7

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