本文選題：連續(xù)性靜脈-靜脈血液濾過 + 燒傷　； 參考：《腎臟病與透析腎移植雜志》2016年01期

【摘要】：目的:探討連續(xù)性靜脈-靜脈血液濾過(CVVH)治療重度燒傷合并急性重度高鈉血癥的療效觀察。方法:回顧性分析2011年3月至2015年3月第四軍醫(yī)大學西京醫(yī)院燒傷ICU 13例重度燒傷合并急性重度高鈉血癥行CVVH治療的患者。置換液鈉梯度是通過加入3%或10%Na Cl,使置換液的鈉濃度低于血鈉濃度8mmol/L,以后每4h下降2 mmol/L。結果:13例患者平均年齡49.1歲(39~57歲),燒傷面積64.2%(44.0%~85.0%)。隨訪28d,死亡3例。CVVH治療后APACHEⅡ評分[21.0(19.5~25.0)vs 24.6(22.0~28.5),P0.001],脈搏[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]和血鈉[138.2 mmol/L(138.3~155.2 mmol/L)vs 166.2 mmol/L(160.9~170.5 mmol/L),P0.001]較治療前均明顯改善。平均血鈉糾正速率為0.62 mmol/(L·h)[0.34~0.89 mmol/(L·h)],CVVH治療48h血鈉均正常。結論:CVVH置換液鈉梯度能有效治療重癥燒傷合并急性重度高鈉血癥。
[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,姝諱骸3渚，

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