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血液透析治疗慢性肾功能衰竭(CRF),可发生多种并发症,其中最常见和严重的是急性左心衰竭(左心衰),它是透析病人的首位死因。正确预防和处理左心衰对延长患者生命至关重要。本文就我院1993年1月—1998年10月1500次血液透析中发生52次(3.42％)血液透析相关性急性左心衰竭的原因探讨如下。 1 临床资料 1.1 一般资料 52例左心衰者均为维持性血液透析患者,其中男35例,女15例。年龄20～71岁,进入透析时间3月～5年,平均12±4月。发生透析前左心衰32例,透析时左心衰12例,透析后左心衰8例。 1.2 原发病 慢性肾小球肾炎28例,糖尿病肾病10例,高血压肾动脉硬化9例,狼疮性肾炎2例,慢性肾盂肾炎3例。 1.3 临床表现及实验室检查 均有少尿或无尿,有急性左心衰竭的典型表现。血压:20.5～31.0/12.0～18.3 kPa,血:Hb29～70 g/L,BUN 26.3～54.2mmol/L,Cr 765～1900μmo1/L。各左心衰组心肺病变情况见表1。
Hemodialysis for chronic renal failure (CRF) can produce a variety of complications, the most common and serious of which is acute left heart failure (left heart failure), which is the leading cause of death in dialysis patients. Correct prevention and treatment of left heart failure is essential to prolong the life of the patient. This article on our hospital in January 1993 - October 1998 1,500 hemodialysis occurred in 52 (3.42%) hemodialysis related to the causes of acute left heart failure are discussed below. 1 Clinical data 1.1 General information 52 cases of left heart failure were maintenance hemodialysis patients, including 35 males and 15 females. Age 20 to 71 years old, into the dialysis time from March to 5 years, an average of 12 ± April. Left heart failure occurred in 32 cases before dialysis, dialysis, left heart failure in 12 cases, 8 cases of left heart failure after dialysis. 1.2 primary disease chronic glomerulonephritis in 28 cases, 10 cases of diabetic nephropathy, hypertensive renal arteriosclerosis in 9 cases, 2 cases of lupus nephritis, chronic pyelonephritis in 3 cases. 1.3 clinical manifestations and laboratory tests have oliguria or anuria, acute heart failure typical performance. Blood pressure: 20.5 ~ 31.0 / 12.0 ~ 18.3 kPa, blood: Hb29 ~ 70 g / L, BUN 26.3 ~ 54.2mmol / L, Cr 765 ~ 1900μmo1 / L. The left heart failure group of heart and lung disease in Table 1.