林彬　冯德广　王锋

[摘要] 目的 探讨心血管外科术后急性肾功能衰竭（ARF）患者的处理方法与效果。 方法 随机抽取我院2011年1月～2015年3月接诊的心血管外科术后ARF患者41例作为研究对象，回顾性分析他们的临床资料，均采取连续性肾脏替代疗法（CRRT）治疗，总结临床效果。 结果 所有患者均顺利完成治疗，存活率为92.68%，均无严重并发症发生；治疗后尿素氮、肌酐、钾离子、氯离子、总胆红素均有明显改善，相较于治疗前差异均有统计学意义（P<0.05），但钠离子对比无显著性差异（P>0.05）；此外，本组患者治疗后SF-36评分要显著高于治疗前，对比差异有统计学意义（P<0.05）。 结论 心血管外科术后急性肾功能衰竭比较常见，应加强重视，而实施CRRT治疗可取得不错的效果，明显改善肾功能指标与生活质量，值得借鉴。

[关键词] 心血管；外科手术；急性肾功能衰竭；连续性肾脏替代；处理

[中图分类号] R654.2 [文献标识码] B [文章编号] 2095-0616（2015）18-116-03

[Abstract] Objective To study the treatment methods and effects of acute renal failure（ARF） after cardiovascular surgical operation. Methods 41 patients with ARF after cardiovascular surgical operation， who were treated in our hospital from January 2011 to March 2015， were randomly selected as the research objects. To retrospectively analyze the clinical data which were treated with continuous renal replacement therapy（CRRT）， to summarize the clinical effect. Results All of the patients were favorably completed the treatment， with the survival rate of 92.68%， without serious complication occurrence. Urea nitrogen， creatinine， potassium ion， chloride ion， total bilirubin after treatment were obviously improved than which before treatment， the differences was statically significant（P<0.05）， while the improvement of sodium ion was no significant difference（P>0.05）， furthermore， the SF-36 score after treatment was significantly higher than which before treatment， the differences was statically significant（P<0.05）. Conclusion CRRT in the treatment of ARF after cardiovascular surgical operation which is more common and should be attached more attention， could obtain good effect， could obvious improve the indexes of renal function and the quality of life， is worthy of reference.

[Key words] Cardiovascular； Surgery； ARF； CRRT； Treatment

心血管外科术后发生急性肾功能衰竭（ARF）属于常见并发症[1-4]，发生原因较多，比如低心输出血量综合征与心脏骤停等引发肾脏血流灌注障碍、药物毒性作用损坏肾脏等[5-6]。为了进一步探讨心血管外科术后急性肾功能衰竭患者的处理方法与效果，我院将CRRT应用在ARF患者中，现将结果报道如下。

1 资料与方法

1.1 一般资料

本次研究共计入选对象41例，全部为我院心血管外科接诊的术后ARF患者，且均为重度患者，入选时间为2011年1月～2015年3月。所有患者入院后均签署知情同意书愿意配合本次研究，其中有男25例、女16例；年龄40～77岁，平均（59.5±10.4）岁；41例患者均辅助应用呼吸机，平均时间（135.02±57.14）h，同时有28例实施主动内气囊反搏术处理，平均时间（95.14±50.19）h；病因为先天性心脏病25例、风湿性心脏病10例、冠心病6例；病程1～5周，平均（2.3±0.8）周。……