摘要
目的观察连续性肾脏替代治疗(continuous renal replacement therapy,CRRT)脓毒血症合并急性肾损伤(acute kidney injury,AKI)的应用价值。方法选取该院2015年1月—2017年2月收治脓毒血症合并AKI患者90例,根据随机数字表法分为对照组及观察组,各45例。对照组接受常规药物治疗,观察组在对照组基础上加用CRRT治疗,观察并比较两组治疗3 d后生命体征、血清学指标及病死率。结果治疗3 d后,观察组收缩压、舒张压、平均动脉压、血氧饱和度、尿量等生命体征指标分别为(113.21±11.24)mm Hg、(65.58±10.34)mm Hg、(80.21±10.04)mm Hg、(96.41±9.51)%、(23.41±5.42)m L/h,均较对照组平稳,差异有统计学意义(P<0.05);治疗3 d后,观察组中性粒细胞、尿素氮、血肌酐、超敏C反应蛋白、降钙素原等血清学指标水平分别为(84.96±3.01)%、(41.56±12.01)mmol/L、(275.11±90.16)μmol/L、(105.41±30.22)mg/L、(1.94±0.17)ng/m L,均低于对照组,差异有统计学意义(P<0.05);观察组治疗1周后病死率为4.44%,同对照组比较,差异无统计学意义(P>0.05),治疗4周后,观察组病死率为6.67%,显著低于对照组,差异有统计学意义(P<0.05)。结论 CRRT治疗脓毒血症合并AKI,有效促进患者血流动力学稳定,患者治疗后生命体征平稳,机体内血清学指标水平均明显下降,全身性炎症反应明显减轻,死亡风险降低,远期疗效显著。
Objective To observe the application value of CRRT in treatment of Sepsis and AKI. Methods 90 cases of sepsis and AKI admitted and treated in our hospital from January 2015 to February 2017 were selected and randomly divided into two groups with 45 cases in each, the control group and the observation group respectively adopted the routine drug treatment and CRRT on the basis of the control group, and the vital signs after 3d treatment, serum index and fatality rate were compared between the two groups. Results After 3d treatment, the systolic pressure, diastolic pressure, MAP, oxygen saturation of blood and urine volume in the observation group were more steady than those in the control group, which were respectively(113.21±11.24)mm Hg,(65.58±10.34)mm Hg,(80.21±10.04)mm Hg,(96.41±9.51)%,(23.41±5.42)m L/h in the observation group, and the differences were statistically significant(P<0.05), after 3 d treatment, the serum index levels of neutrophils, urea nitrogen, serum creatinine, high sensitivity C reactive protein, and procalcitonin were respectively(84.96 ±3.01)%,(41.56 ±12.01)mmol/L,(275.11 ±90.16)μmol/L,(105.41 ±30.22)mg/L,(1.94±0.17)ng/m L, which were lower than those in the control group, and the differences were statistically significant(P<0.05), and the fatality rate in the observation group after 1-week treatment was 4.44%, and the difference between groups was not statistically significant(P>0.05), after four-week treatment, the fatality rate was 6.67%, which was obviously lower than that in the control group, and the difference was statistically significant(P<0.05). Conclusion The CRRT in treatment of sepsis and AKI can effectively promote the hemodynamic stability, make the vital signs of patients after treatment steady and the serum index levels in organism obviously decrease, obviously relieve the general inflammatory reactions and reduce the death risk, and the long-term curative effect is obvious.
出处
《系统医学》
2017年第10期37-39,43,共4页
Systems Medicine
