连续性肾脏替代治疗临床应用的现状况

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连续性肾脏替代治疗临床应用的现状况

南京军区南京总医院  解放军肾脏病研究所(210002) 季大玺 谢红浪 徐 斌

本文就目前对连续性肾脏替代治疗在重症急性肾衰及非肾脏疾病中的应用现状有关文献作一摘 要 

阐述。

关键词 连续性肾脏替代治疗 重症急性肾衰 全身炎症反应综合征

  1977年,Kramer等首次将连续性动静脉血液滤过

(continuousarteriovenoushemofiltration,CAVH)用于临床,很大程度克服了间歇性血液透析(intermittenthemodialysis,IHD)的缺点,从而衍生出多种连续性血液净化技术,目前将这一技术统称为连续性肾脏替代治疗(continuousrenalreplacementtherapy,CR2

RT)[1,2]。CRRT在重症监护病房(ICU)重症急性肾

功能衰竭(acuterenalfailure,ARF),全身炎症反应综合

征(systemicinflammatoryresponsesyndrome,SIRS),多器官功能障碍综合征(multipleorgandysfunctionsyn2drome,MODS),成人呼吸窘迫综合征(adultrepiratorydistresssyndrome,ARDS)和急性坏死性胰腺炎的治疗中的应用已越来越广泛,已是当今危重病患者的主要治疗措施之一,与机械通气和全胃肠外营养(TPN)地位同样重要。尽管如此,CRRT技术的进步是否肯定降低死亡率尚有争议。但是,这一疗法前景至今不衰,

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