摘要
目的评价脓毒性肾衰竭患者使用高容量血液滤过(HVHF)治疗的安全性和有效性。方法收集2014年7月前发表的关于脓毒性肾衰竭患者HVHF治疗与标准容量血液滤过(SVHF)治疗比较的随机对照试验。以28 d病死率、ICU住院时间、器官功能恢复情况、不良事件发生情况作为评估指标。结果共纳入6项试验,1 295例患者。HVHF组与SVHF组在28 d病死率[OR=0.99,95%CI(0.79~1.23),P=0.92]、ICU住院时间[WMD=-0.27,95%CI(-2.13~1.59),P=0.77]、升压药使用剂量、肾功能、呼吸系统恢复情况均无统计学差异,且HVHF治疗组在电解质紊乱、低体温发生等方面更常见。结论 HVHF治疗脓毒性肾衰竭不比SVHF更安全有效,且有较多的不良事件发生。
Objective To evaluate the efficiency and safety of high-volume hemofiltration( HVHF) for the treatment of septic acute kidney failure. Methods A systematic review and meta-analysis of publications was performed before July of 2014. The review was limited to randomized-controlled trials that compared HVHF vs standard-volume hemofiltration( SVHF) in the treatment of sepsis acute kidney. The outcomes assessed were 28-day mortality,ICU lengths of stay,recovery of organ function and adverse events. Results Six trials,including1 295 total patients were included. The outcome of 28-day mortality[OR = 0. 99,95% CI( 0. 79 ~ 1. 23),P = 0. 92 ],ICU lengths of stay[WMD =- 0. 27,95% CI(- 2. 13 ~ 1. 59),P = 0. 77],recovery of kidney function,recovery of respiratory system and dose of vasopressors did not show significant statistical significance between HVHF and SVHF. It was more common that people had the hypothermia,electrolyte disturbance in HVHF treatment group. Conclusion HVHF treatment of septic renal failure is not necessarily safer and more effective than SVHF,and many adverse events may happen.
出处
《安徽医学》
2015年第3期278-281,共4页
Anhui Medical Journal
