连续性静脉-静脉血液滤过治疗重度烧伤合并急性重度高钠血症

发布时间：2018-04-13 19:51

  本文选题：连续性静脉-静脉血液滤过 + 烧伤　； 参考：《肾脏病与透析肾移植杂志》2016年01期

【摘要】：目的:探讨连续性静脉-静脉血液滤过(CVVH)治疗重度烧伤合并急性重度高钠血症的疗效观察。方法:回顾性分析2011年3月至2015年3月第四军医大学西京医院烧伤ICU 13例重度烧伤合并急性重度高钠血症行CVVH治疗的患者。置换液钠梯度是通过加入3%或10%Na Cl,使置换液的钠浓度低于血钠浓度8mmol/L,以后每4h下降2 mmol/L。结果:13例患者平均年龄49.1岁(39~57岁),烧伤面积64.2%(44.0%~85.0%)。随访28d,死亡3例。CVVH治疗后APACHEⅡ评分[21.0(19.5~25.0)vs 24.6(22.0~28.5),P0.001],脉搏[107.0次/min(93.0~120.0次/min)vs 123次/min(116~136次/min),P=0.028)]、尿素氮[13.4mmol/L(12.1~15.5 mmol/L)vs 22.7 mmol/L(15.4~34.3 mmol/L),P=0.018]、肌酐(167.6μmol/L(105.5~240.5)μmol/L vs 257.2μmol/L(146~399.0)μmol/L,P=0.014]和血钠[138.2 mmol/L(138.3~155.2 mmol/L)vs 166.2 mmol/L(160.9~170.5 mmol/L),P0.001]较治疗前均明显改善。平均血钠纠正速率为0.62 mmol/(L·h)[0.34~0.89 mmol/(L·h)],CVVH治疗48h血钠均正常。结论:CVVH置换液钠梯度能有效治疗重症烧伤合并急性重度高钠血症。
[Abstract]:Objective: to investigate the therapeutic effect of CVVH on severe burn with acute and severe hypernatremia.Methods: from March 2011 to March 2015, 13 patients with severe burn associated with acute and severe hypernatremia treated with CVVH in Xijing Hospital of fourth military Medical University were retrospectively analyzed.By adding 3% or 10%Na Cl, the sodium gradient of the replacement solution is lower than that of the blood sodium concentration of 8 mmol / L, and then decreases by 2 mmol / L every 4 h.Results the average age of 13 patients was 49.1 years old and 3957 years old. The burn area was 64.2% and 85.0%.闅忚��28d,姝讳骸3渚，

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