李俊++++++李斌++++++代永红++++++付世全

    [摘要] 目的 評价血液透析联合连续静-静脉血液滤过(CVVH)治疗蜂蜇伤合并心衰的临床效果。 方法 回顾性分析重庆市江津区中心医院2014年3月～2016年3月收治的74例蜂蜇伤合并心衰患者的临床资料，按照治疗方法分为观察组(37例)和对照组(37例)，两组均在常规治疗的基础上给予血液透析，观察组加用CVVH。比较两组患者治疗前后生化指标变化及透析相关并发症发生情况，分析血液透析联合CVVH的临床疗效与安全性。 结果 观察组住院时间低于对照组，置换/透析液剂量、超滤量大于对照组，治疗费用高于对照组，差异有统计学意义(P 0.05)。观察组病死率为2.70%(1/37)，小于对照组的13.51%(5/37)，差异有统计学意义(P 0.05)。 结论 较单纯血液透析而言，血液透析联合CVVH能够在保证治疗安全性的前提下缩短患者恢复时间、提高临床总有效率，对患者生存质量的改善具有积极意义，但是高昂的治疗成本可能造成推广范围受限。

    [关键词] 血液透析；连续静-静脉血液滤过；蜂蜇伤；心衰

    [中图分类号] R646 [文献标识码] A [文章编号] 1673-7210(2017)02(b)-0113-04

    [Abstract] Objective To evaluate the clinical effect of hemodialysis combined with continuous veno venous hemofiltration (CVVH) treating bee sting patients with heart failure. Methods From March 2006 to March 2016， in Center Hospital of Jiangjin District， the clinical data of 74 bee sting patients with heart failure were retrospective analyzed， they were divided into observation (37 cases) group and control group (37 cases)， they were treated with hemodialysis on the basis of conventional treatment， the observation group added with CVVH. The changes of biochemical indexes and dialysis related complications before and after treatment in two groups were compared ......