Clinical Effect Of Continuous Renal Replacement Therapy(CRRT) In Uremia With Cardiopulmonary Failure

Objective:To determine the clinical effect of CRRT in uremia with cardiopulmonary failure.Methods:A total of 96 cases of uremia patients with cardiopulmonary failure admitted to our hospital from January 2020 to January 2021 were divided into treatment group and reference group according to odd and even grouping method,with 48 cases in each group.Patients in the reference group received subcutaneous injection of heparin sodium for anticoagulant therapy and routine hemodialysis treatment.Patients in the treatment group received continuous renal replacement therapy（CRRT）;General sociological data,renal function（Scr,BUN,UA）,electrolytes(CI^-,K⁺,Na⁺,HCO^3-),cardiac function parameters（LVEDd,LVESd,FS,EF（%）,CK-MB,pro-BNP）,hemodynamic indicators（HR,MBP,MRAP,MPVP,P）of 2 groups were analyzed AWP,PVR),lung function（FVC,VC,TLC,RV）,inflammatory factors（IL-6,TNF-α）;The adverse reactions（drowsiness,unconsciousness,agitation,flutter-like shock）and treatment effect were analyzed.Results:There were no significant differences in average age,gender（male and female）,course of disease,cardiac function grade（grade III and grade IV）,and primary diseases（chronic glomerulonephritis,diabetic nephropathy,chronic pyelonephritis,and others）between 2 groups（P>0.05）.Before treatment,there was little difference in renal function,cardiopulmonary function,electrolyte balance,inflammatory response and other factors between the two groups（P>0.05）.After treatment,renal function factors（Scr,BUN,Cys C）,electrolytes（CI^-,K⁺,Na⁺）,cardiac function（LVEDd,LVEDs）,hemodynamic indexes（MRAP,MPVP,PAWP）,pulmonary function indexes（RV）,inflammatory factors（TNF-α,IL-6）,myocardial injury factor（NT-PRO）BNP,CK-MB)showed a downward trend.Carbonate ion（HCO3-）,LVEF（%）,FS（%）,VC,FVC and TLC were all up-regulated.The improvement of renal function,cardiopulmonary function,electrolyte balance,inflammatory and myocardial injury factors in the treatment group was significantly better than that in the control group,and the data were statistically significant（P<0.05）.The incidence of adverse reactions（drowsiness,unconsciousness,agitation and flutter）in the treatment group（4.17%）was significantly lower than that in the control group（18.75%）,and the difference was statistically significant（P<0.05）.The total effective rate of reference group（33（68.75%））was lower than that of observation group(39（81.25%）,the difference was statistically significant（P<0.05）.Conclusion:Continuous renal replacement therapy（CRRT）has a significant effect on uremia with cardiopulmonary failure,significantly improving patients’cardiopulmonary function,promoting the stability of electrolyte and hemodynamic balance in the body,with rare adverse reactions and higher treatment safety,which is worthy of clinical application.