摘要
目的探讨速尿微泵持续静脉内注射治疗急性肾功能衰竭少尿期的临床疗效。方法采用随机对照方法，将36例急性肾功能衰竭少尿期患者分为微泵持续静脉注射组（微泵维持组）和分次静脉注射组（分次静注组），均使用大剂量速尿5～10mg／（kg·d）。微泵维持组在第一次静脉注射100mg后，采用微泵维持24h；分次静注组分4次／d静脉注射。分别观察并比较两种方法治疗前与治疗后3d每天24h尿量、治疗后第1天每2h尿液流量、治疗3d后血尿素氮及血肌酐值及非少尿型肾衰的比率、治疗过程中需要透析的患者比率、肾功能恢复时间以及28d死亡率。结果微泵维持组利尿效果明显优于分次静注组，尤其在治疗的第2天、第3天利尿效果尤为明显（P〈0．01）；每2h尿液流量微泵维持组与分次静注组比较相对平稳；治疗3d后两组患者血尿素氮及肌酐值比较差异无显著性（P〉0．05）；非少尿型肾衰比率微泵维持组较分次静注组明显高（P〈0．05），而需要透析的患者比率低（P〈0．05）；肾功能恢复时间及死亡率方面两组比较差异无显著性（P〉0．05）。结论大剂量速尿采用微泵静脉内注射治疗急性肾功能衰竭的利尿效果明显优于传统的分次静脉注射，是缩短少尿期、向非少尿型转变、减少急性肾功能衰竭患者透析比率的有效措施，但对于肾功能恢复及死亡率无改善作用。
Objective To evaluate the clinical effect of continuous infusion of furosemide by intravenous pump in the patients with acute renal failure（ARF）at the oliguric stage. Methods Patients with oliguric acute renal failure were randomly divided into two groups accepting high dose furosemide 5～10 mg·kg^-1·d^-1, one group were given continuons intravenous infusion of furosemide by intravenous pump during 24 hours after the administration of 100 mg furosemide, the other group were treated with intravenous intermittent injection of furosemide for 4 times one day.The information of the 24 - hour urine volume before and after 3- day treatment, the urine flow of every 2 hours at the fwst day after treatment, the blood urea nitrogen, creatinine, the ratio of non - oliguric renal failure, the ratio of the patients needed dialysis during the period of treatment, the recovery time of renal function and the mortality of 28 days were collected respectively. Results Administration of high dose furosemide by intravenous pump had a obvious improvement in the efficiency of diuresis, especially at the second and third day（P〈0.05） ; Furthermore, this form of administration provided the more consistent urine flow in every 2 hours , there＇s no significant difference in blood urea nitrogen and creatinine between the two groups（P〉0.05）, but the use of continuous infusion diuretics provided a marked higher ratio of non-oliguric renal failure（P〈0.05） and a lower ratio of the patients needed dialysis（P〈0.05） compared with that of intravenous intermittent injections . No remarkable difference had been detected in recovery time of renal function and the mortality between the two groups. Conclusion Continuous infusion of high dose furosemide by intravenous pump in patients with oliguric acute renal failure is superior to the conventional intermittent injection, and is the effective method for shortening the oliguric period, changing into a non-oliguric style of ARF and decreasing the number of dialysis; However, duration of renal failure and mortality were not different in the two groups.
出处
《中国急救医学》
CAS
CSCD
北大核心
2006年第3期178-180,共3页
Chinese Journal of Critical Care Medicine
关键词
速尿
急性肾功能衰竭
微泵
治疗
Furosemide
Acute renal failure（ARF）
Intravenous pump
Treatment
