KDIGO标准在MODS合并AKI患者选择血液净化治疗时机中的临床意义

Clinical Significance of KDIGO Standards in the Patients with MODS Combined with AKI in Time Selection for Blood Purification Therapy

目的探讨KIDGO标准在MODs合并AKI患者选择血液净化治疗时机中的临床意义。方法选取本院150例MODS合并AKI需要进行血液净化治疗的患者，根据KDIGO标准和APACHEⅡ评分将其分为KDIGO1、2、3期三组和APACHEII评分〈159、15～25分、〉25分三组。分别对各组患者的存活率、存活患者肾功能改善率、平均住院时间、治疗费用及CBP治疗超滤总量进行比较。结果KDIGO1、2期的患者存活率、存活患者肾功能改善率、平均住院时间、治疗费用及CBP治疗超滤总量均显著优于APACHE Ⅱ评分≤25分的患者，差异具有统计学意义（P〈0．05）。KDIGO3期患者的存活率、存活患者肾功能改善率、平均住院时间、治疗费用及CBP治疗超滤总量，与APACHEU评分〉259患者的差异无统计学意义（P〉0．05）。结论KDIGO1、2期对患者进行血液净化治疗可显著提高治疗效果。

Objective To explore the clinical significance of KDIGO standards in the patients with MODS combined with AKI for the time selection of blood purification therapy. Method 150 patients with MODS/AKI were selected in our hospital who needed blood purification, and then were divided into three groups of KDIGO 1,2,3 according to the KDIGO criteria and three groups of APACHE Ⅱ scored 〈15,15 to 25,〉 25 according to the APACHE Ⅱ criteria. The survival rate of patients in each group and the renal function improvement, average length of being hospitalized, cost of treatment and the total amount of CBP ultrafiltration treatment were respectively compared. Result The survival rates, renal function improvement, the average length of being hospitalized, the total cost of treatment and ultrafiltration of CBP treatment of the KDIGO1,2 patients were significantly better than patients whose APACHE Ⅱ score ≤25 points, the difference was statistically significant（P〈0.05）. KDIGO3 patients＇ survival rates, renal function improved survival rates, average length of stay, treatment costs and CBP treatment＇ s total ultrafiltration had no significant difference with patients in group of APACHE Ⅱ score〉25（P〉0.05）. Conclusion The blood purification treatment on the patients in the period of KDIGO1 and 2 can significantly improve the therapeutic effect.