比较不同介入时机的连续性肾脏替代治疗脓毒症致急性肾损伤的临床疗效

To compare the clinical effect of continuous renal replacement therapy with different interventional time on acute renal injury caused by sepsis

目的探究在连续性肾脏替代疗法治疗脓毒症致急性肾损伤患者不同介入治疗时机的疗效。方法2021年8月-2022年10月,连续性肾脏替代疗法的脓毒症致急性肾损伤患者80例,随机分为40例,对照组于早期开展连续性肾脏替代疗法,试验组于晚期开展连续性肾脏替代疗法,对比治疗效果。结果在治疗前,PCT、IL-10、IL-6、TNF-ɑ,2组对比无差异,P>0.05,治疗后,炎症介质水平2组均有下降,而且组间对比试验组相关指标均低于对照组,P<0.05;治疗后,ICU住院时间、总住院时间试验组短于对照组,P<0.05;在治疗前,针对两组相关生化指标对比,即BU、Scr、N%等指标,表示无差异,P>0.05,在治疗后48小时,2组以上指标均有改善,而且组间对比试验组BUN、Scr、N%水平低于对照组,P<0.05;统计两组住院病死率、90天后病死率,试验组均少于对照组,P<0.05。结论在连续性肾脏替代疗法治疗脓毒症致急性肾损伤时,早期开展介入治疗,效果显著,且还能减少死亡率与病死率,值得推荐。

Objective To explore the efficacy of continuous renal replacement therapy in the treatment of sepsis induced acute kidney injury patients with different interventional therapy timing.Methods From August 2021 to October 2022,80 patients with sepsis induced acute kidney injury receiving continuous renal replacement therapy were randomly divided into 40 patients.The control group received continuous renal replacement therapy in the early stage,and the experimental group received continuous renal replacement therapy in the late stage,and the therapeutic effect was compared.Results Before treatment,PCT,IL-10,IL-6 and TNF-alpha showed no difference between the two groups(P>0.05).After treatment,the levels of inflammatory mediators in both groups decreased,and the relevant indexes in the experimental group were all lower than those in the control group(P<0.05).After treatment,the length of ICU stay and total length of ICU stay in experimental group were shorter than those in control group,P<0.05;Before treatment,the comparison of relevant biochemical indicators between the two groups,namely BU,Scr,N%and other indicators,showed no difference,P>0.05.48 hours after treatment,the above indicators of the two groups were improved,and the BUN,Scr,N%levels of the experimental group were lower than those of the control group,P<0.05;The case fatality rate in hospital and 90 days after treatment in experimental group was lower than that in control group(P<0.05).Conclusion In the treatment of acute kidney injury caused by sepsis by continuous renal replacement therapy,early interventional therapy is effective and can reduce mortality and mortality,which is worthy of recommendation.