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目的:探讨碳酸盐血液透析(BD)救治慢性肾功能衰竭(CRF)尿毒症期并发顽固难治急性左心衰竭的疗效与安全性。方法:对经内科常规治疗无效,血氧无改善的46例CRF尿毒症期并发顽固难治急性左心衰竭病例,改用BD行超滤脱水等进行救治。结果:46例患者均能耐受2~4hBD,透析后血压、心率、呼吸较BD前明显下降,血氧饱和度较BD前明显升高,差异具有统计学意义。救治成功率94.03%,未见BD急性并发症。结论:内科常规疗法救治CRF尿毒症期并发顽固难治急性左心衰竭患者,紧急应用BD行超滤脱水进行救治,是一种安全、有效的救治措施,成功率较高,值得临床进一步探讨。
Objective: To investigate the efficacy and safety of carbonated hemodialysis (BD) in the treatment of refractory acute left heart failure complicated with chronic renal failure (CRF) uremia. Methods: In 46 cases of CRF uremia with no improvement of conventional oxygen therapy and no improvement of blood oxygen, patients with refractory acute left heart failure were treated by BD ultrafiltration and dehydration. Results: All 46 patients tolerated 2 ~ 4 hBD. After dialysis, blood pressure, heart rate and respiration decreased significantly compared with those before BD. The oxygen saturation was significantly higher than that before BD. The difference was statistically significant. Treatment success rate of 94.03%, no acute complication of BD. CONCLUSION: It is a safe and effective treatment for emergency treatment of patients with refractory acute left heart failure who are refractory to acute left heart failure during the treatment of CRF uremia with routine therapy. It is a safe and effective treatment and has a high success rate. It is worth further clinical study.