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目的观察间断血液透析在治疗顽固性心衰并急性肾损伤的疗效。方法选取2014年1月—2016年1月华北理工大学附属医院心内科住院的利尿剂抵抗药物治疗无效的顽固性心衰并急性肾损伤患者23例,均给予间断血液透析治疗,观察临床疗效。结果治疗后患者的心衰症状均得到明显缓解,肺水肿或肺淤血消失;尿素氮、血肌酐、血压、心率、血氧饱和度、左心室射血分数、氨基末端B型脑钠肽前体(BNP)有明显改善,治疗前后比较差异有统计学意义(P<0.05);并恢复对利尿剂的敏感性,停止透析及超滤,继续使用药物维持治疗。结论间断血液透析治疗顽固性心衰并急性肾损伤效果显著,并可恢复患者对利尿剂的敏感性。
Objective To observe the curative effect of intermittent hemodialysis on refractory heart failure and acute renal injury. Methods Twenty-three patients with refractory refractory heart failure and acute kidney injury who were hospitalized in Department of Cardiology, Affiliated Hospital of North China University of Technology from January 2014 to January 2016 were treated with intermittent hemodialysis, and the clinical efficacy was observed. Results The symptoms of heart failure were significantly relieved in patients after treatment. Pulmonary edema or pulmonary congestion disappeared. The levels of blood urea nitrogen, serum creatinine, blood pressure, heart rate, oxygen saturation, left ventricular ejection fraction, (BNP) were significantly improved before and after treatment, the difference was statistically significant (P <0.05); and to restore the sensitivity of diuretics, stop dialysis and ultrafiltration, continue to use drug maintenance treatment. Conclusion Intermittent hemodialysis treatment of refractory heart failure and acute renal injury significantly, and can restore the patient’s sensitivity to diuretics.