肖晶晶武汉亚洲心脏病医院重症恢复室，湖北武汉　430000

主动脉夹层术后急性肾功能衰竭患者的CRRT治疗效果分析

肖晶晶
武汉亚洲心脏病医院重症恢复室，湖北武汉430000

目的 探讨主动脉夹层患者外科手术后出现急性肾功能衰竭行连续性肾脏替代治疗（CRRT）的效果。方法选择我院2011年1月～2015年12月间主动脉夹层术后出现急性肾功能衰竭应用CRRT治疗的32例患者，回顾性评估肾功能、电解质、乳酸、中心静脉压、心率等相关指标变化情况。结果 治疗后血pH值、动脉血氧分压较治疗前升高，肌酐、尿素氮、血钾、乳酸、中心静脉压较治疗前明显下降，差异有统计学意义（P＜0.05）；治疗前后平均动脉压和心率比较，差异无统计学意义（P＞0.05）。结论研究表明CRRT对治疗主动脉夹层术后急性肾功能衰竭患者是安全有效的。

主动脉夹层；急性肾功能衰竭；连续性肾脏替代治疗；术后

[Abstract]Objective To summarize the treatment effect of continuous renal replacement therapy(CRRT)for the patients with postoperative acute renal failure of aortic dissection.Methods Research analysis of our hospital from January 2011 to December 2015,32 cases postoperatively in patients with aortic dissection in acute renal failure applying CRRT treatment,the renal function,electrolytes,lactic acid,central venous pressure,heart rate and related index changes were retrospective assessed.Results After treatment the pH,arterial partial pressure of oxygen was increased,creatinine,urea nitrogen,potassium and lactic acid,central venous pressure drop were statisticallly decreased than that of before treatment,the differences were statistically significant(P<0.05)；differences of mean arterial pressure and heart rate between before and after treatment were not statistically significant(P>0.05).Conclusion This research shows that CRRT is an effective safe treatment of aortic dissection in patients with acute renal failure after aortic dissection.

[Key words]Aortic dissection;Acute renal failure;Continuous renal replacement therapy；After the operation

主动脉夹层（aortic dissection）是指主动脉内的血液从主动脉内膜破裂口进入主动脉中膜，并沿主动脉长轴方向扩展，造成主动脉真假两腔分离的一种病理改变，因通常呈继发瘤样改变，故将其称为主动脉夹层动脉瘤。临床特点为急性起病，突发剧烈疼痛、休克和血肿压迫相应的主动脉分支血管时出现的脏器缺血症状[1]。当降主动脉夹层向远端扩展时可累及腹主动脉及其分支、髂总动脉，引起相关内脏及下肢缺血症状，尤其是肾组织缺血，可致肾动脉狭窄甚至闭塞，严重时导致急性肾衰竭[2]。目前治疗主动脉夹层最好的办法……