摘要
目的:探讨连续肾脏替代疗法(continuous renal replacement therapy,CRRT)治疗脓毒症伴急性肾损伤患者的效果。方法:回顾性选取2021年1月—2023年6月漳州市中医院重症医学科收治的80例脓毒症伴急性肾损伤患者。根据不同治疗方式将其分为CRRT组(40例)和间歇性血液透析疗法(intermittent hemodialysis,IHD)组(40例)。CRRT组给予CRRT,IHD给予IHD。比较两组治疗前、治疗1周后肾功能、肾血流动力学、炎症因子及病情。结果:治疗1周后,两组血肌酐(serum creatinine,Scr)、血尿素氮(blood urea nitrogen,BUN)均降低,白蛋白(albumin,ALB)升高,CRRT组Scr、BUN水平均低于IHD组,差异有统计学意义(P<0.05)。治疗1周后,两组峰值强度(peak intensity,PI)、平均渡越时间(mean transit time,MTT)、曲线下面积(area under the curve,AUC)均升高,CRRT组PI、MTT、AUC均高于IHD组,差异有统计学意义(P<0.05)。治疗1周后,两组C反应蛋白(C-reactive protein,CRP)、降钙素原(pocalcitonin,PCT)、白细胞计数(white blood cell,WBC)均降低,CRRT组CRP、PCT、WBC均低于IHD组,差异有统计学意义(P<0.05)。治疗1周后,两组急性生理与慢性健康状况Ⅱ(acute physiology and chronic health evaluationⅡ,APACHEⅡ)评分均降低,CRRT组APACHEⅡ评分低于IHD组,差异有统计学意义(P<0.05)。结论:CRRT治疗脓毒症伴急性肾损伤在改善肾功能、肾血流动力学及炎症反应方面效果更佳。
Objective:To explore the effect of continuous renal replacement therapy(CRRT)in the treatment of patients with sepsis and acute kidney injury.Method:A total of 80 patients with sepsis and acute kidney injury admitted to the Intensive Care Department of Zhangzhou Traditional Chinese Medicine Hospital from January 2021 to June 2023 were retrospectively selected.They were divided into CRRT group(40 cases)and intermittent hemodialysis(IHD)group(40 cases)according to different treatment methods.The CRRT group was given CRRT and the IHD group was given IHD.Renal function,renal hemodynamics,inflammatory factors and condition were compared between the two groups before treatment and after 1 week of treatment.Result:After 1 week of treatment,serum creatinine(Scr)and blood urea nitrogen(BUN)were decreased and albumin(ALB)were increased in both groups,Scr and BUN levels in CRRT group were lower than those in IHD group,the differences were statistically significant(P<0.05).After 1 week of treatment,the peak intensity(PI),mean transit time(MTT)and area under the curve(AUC)of the two groups were increased,and the PI,MTT and AUC of the CRRT group were higher than those of the IHD group,the differences were statistically significant(P<0.05).After 1 week of treatment,C-reactive protein(CRP),pocalcitonin(PCT)and white blood cell(WBC)count decreased in both groups,while CRP,PCT and WBC in CRRT group were lower than those in IHD group,the differences were statistically significant(P<0.05).After 1 week of treatment,the acute physiology and chronic health evaluationⅡ(APACHEⅡ)scores of both groups were decreased,and the APACHEⅡscores of the CRRT group were lower than those of the IHD group,the differences were statistically significant(P<0.05).Conclusion:CRRT is better in improving renal function,renal hemodynamics and inflammatory response in the treatment of sepsis with acute renal injury.
作者
梁银娇
易柳青
吴登鹏
LIANG Yinjiao;YI Liuqing;WU Dengpeng(Zhangzhou Traditional Chinese Medicine Hospital,Zhangzhou 363000,China;不详)
出处
《中外医学研究》
2024年第16期57-61,共5页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
脓毒症
急性肾损伤
连续肾脏替代疗法
间歇性血液透析疗法
肾功能
炎症反应
Sepsis
Acute kidney injury
Continuous renal replacement therapy
Intermittent hemodialysis therapy
Renal function
Inflammatory reaction
