摘要
目的 探讨连续性肾替代治疗(CRRT)脓毒症合并急性肾损伤(AKI)的效果。方法 选取2018年6月至2020年11月我院收治的96例合并AKI的脓毒症患者,将其随机分为对照组与研究组,每组各48例;对照组给予常规治疗和间歇性血液透析(Intermittent hemodialysis,IHD)治疗,研究组给予常规治疗和CRRT治疗;比较两组的生命体征指标[平均动脉压(Mean arterial pressure,MAP)、心率(Heart rate,HR)、血氧饱和度(Pulse oxygen saturation,SPO_(2))、尿量]、血清指标[血清超敏C反应蛋白(High sensitivity C-reactive protein,hs-CRP)、肿瘤坏死因子α(Tumor necrosis factor-α,TNF-α)],使用免疫比浊法检测血清肌酐(Serum creatinine, Scr)、血清尿毒氮(Blood uremic nitrogen,BUN)、比较疗效指标(尿量恢复时间、器官支持时间、ICU住院时间及心血管事件发生率)等。结果治疗后,研究组的MAP、尿量均高于对照组(P<0.05),而研究组的HR则低于对照组(P<0.05);研究组的hsCRP、TNF-α、Scr、BUN等指标水平均低于对照组(P<0.05);研究组的尿量恢复时间、器官支持时间、ICU住院时间及心血管事件发生率均低于对照组(P<0.05)。结论 与IHD相比,脓毒症合并AKI患者通过CRRT治疗后,可稳定生命体征,减轻炎症反应,改善肾脏功能,提高治疗效果,值得在临床推广应用。
Objective To explore the efficacy of continuous renal replacement therapy(CRRT)on sepsis complicated with acute kidney injury(AKI).Methods A total of 96 sepsis patients complicated with AKI admitted to and treated in our hospital from June 2018 to November 2020 were selected,and they were randomLy divided into the control group(n=48)and the study group(n=48).The control group was treated with conventional treatment and intermittent hemodialysis(IHD),while the study group was treated with conventional treatment and CRRT.The vital signs(mean arterial pressure(MAP),heart rate(HR),pulse oxygen saturation(SPO_(2)),urine volume),serum indices(high sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)were compared between the two groups.Immunoturbidimetry was used to compare the serum creatinine(Scr),blood uremic nitrogen(BUN),therapeutic efficacy indices(recovery time of urine volume,organ support time,ICU hospitalization time and cardiovascular event rate),etc.Results After treatment,the MAP and urine volume level of the study group were all higher than those of the control group(P<0.05),while the HR level of the study group was lower than that of the control group(P<0.05).The levels of hs-CRP,TNF-α,Scr and BUN in the study group were all lower than those in the control group(P<0.05).The recovery time of urine volume,organ support time,hospitalization time in intensive care unit(ICU)and the incidence of cardiovascular events in the study group were all lower than those in the control group(P<0.05).Conclusion Compared with IHD,patients with sepsis complicated with AKI can stabilize vital signs,reduce inflammatory reaction,improve renal function and increase therapeutic efficacy after CRRT treatment,which is worthy of clinical promotion and application.
作者
吴玉琴
刘凤琪
沈旭慧
陈志冬
霍中翠
WU Yuqin;LIU Fengqi;SHEN Xuhui;CHEN Zhidong;HUO Zhongcui(Intensive Care Unit,the First People′s Hospital of Huzhou City in Zhejiang Province,Huzhou313000,China;Huzhou University,Huzhou 313000,China;Hemodialysis Room,the First People′s Hospital of Huzhou City in Zhejiang Province,Huzhou313000,China)
出处
《中国现代医生》
2021年第26期126-129,共4页
China Modern Doctor
基金
浙江省医药卫生科技计划项目(2021KY1094)。
关键词
脓毒症
急性肾损伤
连续性肾脏替代治疗
间歇性血液透析
Sepsis
Acute kidney injury
Continuous renal replacement therapy
Intermittent hemodialysis
