不同透析方式对颅脑外伤合并ARF患者预后的影响The influence of different dialysis methods on the prognosis of patients with traumatic brain injury and ARF
贾建成;孙东辉;夏冬雪;王彦彬;
摘要(Abstract):
目的探讨不同透析方法对颅脑外伤合并急性肾衰竭(ARF)患者预后的影响。方法选取颅脑外伤合并ARF患者97例,按透析方式分为间歇性血液透析组(IHD组,n=41)及连续肾脏替代治疗组(CRRT组,n=56),比较2组透析治疗前后尿素氮(BUN)、血肌酐(Scr)、电解质(血钾、血钠、血氯)水平及白介素-1(IL-1)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)等因子的变化;比较2组脑脊液压力及血浆渗透压变化;检测透析前后血红蛋白(Hb)、白蛋白(ALB)、瘦素(Leptin)、体重指数(BMI)变化;统计透析相关并发症发生率及随访1 a存活率。结果透析2周后CRRT组BUN、Scr、血钾低于IHD组,血钠、血氯高于IHD组(P<0.05),IL-1、IL-6、TNF-α、hs-CRP低于IHD组(P<0.05);CRRT组透析前后脑脊液压力及血浆渗透压差值低于IHD组(P<0.05);CRRT组低血压发生率低于IHD组,1 a存活率高于IHD组(P<0.05)。结论 CRRT透析治疗颅脑外伤合并ARF整体价值优于IHD,可减少患者脑血流波动,减轻炎症反应,保护肾功能,减少并发症,提高近期存活率。
关键词(KeyWords): 颅脑外伤;急性肾衰竭;连续肾脏替代;间歇性血液透析;肾功能
基金项目(Foundation): 2019年河南省医学科技攻关计划共建项目(编号:LHGJ20191455)
作者(Author): 贾建成;孙东辉;夏冬雪;王彦彬;
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DOI:
参考文献(References):
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