Gaspar Luis Jorge Rodrigues, Moreira Nelson Martins, Moutinho Aires Ademar, Moreira Pinto Paulo Jorge, Lima Helder Brízida
Hospital São João, Nephrology Department, Oporto, Portugal.
EDTNA ERCA J. 2002;Suppl 2:19-22. doi: 10.1111/j.1755-6686.2002.tb00250.x.
Continuous Renal Replacement Therapy (CRRT) is frequently used in patients admitted to intensive care units with multiple organ failure and acute renal failure. These patients are prone to developing hypotension making it very difficult to use conventional haemodialysis for their treatment. When compared to conventional haemodialysis CRRT has obvious clinical advantages. These advantages are mostly due to slow volume and uraemic toxin removal leading to better haemodynamic tolerability for such patients. In our unit during the year 2000, 58 patients were submitted to CRRT: 14 of the patients underwent treatment with continuous veno-venous haemofiltration and 44 were submitted to continuous veno-venous haemodiafiltration. The mean patient age was 61.7 years (range: 20-87), 36 male and 22 females. Twenty patients (43.1%) had sepsis, 18 (31%) were post open-heart surgery, 7 (12%) had multiple organ failure, 4 (6.9%) were polytraumatised, 3 (5.2%) were post neurosurgery and 1 (1.8%) was a liver transplant patient. Despite the grave prognosis of these patients, 22 (37.8%) survived and 36 (62.2%) died. Of the patients that survived, 10 (17.2%) recovered renal function and 12 (20.6%) remained on a regular haemodialysis programme. The authors conclude that CRRT seems to be an alternative to conventional haemodialysis for the treatment of those patients with acute renal failure.
连续性肾脏替代治疗（CRRT）常用于入住重症监护病房的多器官功能衰竭和急性肾衰竭患者。这些患者容易发生低血压，使得使用传统血液透析进行治疗非常困难。与传统血液透析相比，CRRT具有明显的临床优势。这些优势主要归因于其缓慢的容量和尿毒症毒素清除速度，从而为此类患者带来更好的血流动力学耐受性。在我们科室，2000年有58例患者接受了CRRT治疗：其中14例患者接受了连续性静脉-静脉血液滤过治疗，44例接受了连续性静脉-静脉血液透析滤过治疗。患者的平均年龄为61.7岁（范围：20 - 87岁），男性36例，女性22例。20例患者（43.1%）患有败血症，18例（31%）为心脏直视手术后患者，7例（12%）有多器官功能衰竭，4例（6.9%）为多发伤患者，3例（5.2%）为神经外科手术后患者，1例（1.8%）为肝移植患者。尽管这些患者预后严重，但22例（37.8%）存活，36例（62.2%）死亡。在存活的患者中，10例（17.2%）肾功能恢复，12例（20.6%）继续接受定期血液透析治疗。作者得出结论，对于急性肾衰竭患者的治疗，CRRT似乎是传统血液透析的一种替代方法。
