摘要
目的:比较连续性与间歇性肾脏替代治疗(renal replacement therapy,RRT)对多器官功能障碍综合征的临床疗效。方法:从2015年10月到2018年3月,选择本院重症监护室(ICU)接受RRT治疗的多器官功能障碍综合征患者作为研究对象。患者随机接受连续性RRT(n=44)与间歇性RRT(n=46)。主要观察指标是RRT结束后28 d的生存率。次要结果指标包括28 d和60 d的院内死亡率,ICU的住院天数,停用RRT的时间,血管加压药/机械通气总天数,疾病严重程度。结果:两组在RRT后28 d生存率,以及28 d、60 d和全因死亡率均无显著差异(P>0.05),并且两组在ICU住院到死亡的时间、ICU住院时间、住院时间、死亡原因、RRT治疗时间、无透析时间、机械通气总时间均无显著差异(P>0.05)。两组之间大多数不良事件的发生率没有显著差异(P>0.05)。与连续性RRT组相比,间歇性RRT组较少发生低体温事件(18.2%vs.4.3%,P<0.05)。结论:在多器官功能障碍综合征的急性肾衰竭患者中,采用连续性RRT或间歇性RRT具有相同的临床疗效。
Objective:To compare the clinical effects of continuous and intermittent renal replacement therapy(RRT)on multiple organ dysfunction syndrome.Methods:From October 2015 to March 2018,patients with multiple organ dysfunction syndrome treated with RRT in our intensive care unit(ICU)were selected as the study subjects.Patients were randomized to receive either CRRT(n=44)or IRRT(n=46).The primary outcome measure was survival 28 days after the end of RRT.Secondary outcome measures included 28-day-,60-day-,all cause intrahospital mortality,days until death(on ICU),days of ICU/hospital stay,days of RRT/dialysis-free days,total days on vasopressors/mechanical ventilation,and course of disease severity.Results:Survival at 28 days after RRT,28-day-,60-day-and all-cause intrahospital mortality rates were not different between the two groups(P>0.05).There were no significant differences in the days until death(on ICU),ICU hospitalization time,hospitalization time,the cause of death,RRT treatment time,dialysis-free time and the total duration of mechanical ventilation between the two groups(P>0.05).There was no significant difference in the incidence of most adverse events between the two groups(P>0.05).Compared with the CRRT group,the IRRT group had fewer hypothermia events(18.2%vs.4.3%,P<0.05).Conclusion:In patients with acute renal failure as part of multiple-organ dysfunction syndrome,CRRT or IRRT has the same clinical efficacy.
作者
黄武军
郭利洁
黄志卫
李任文
黄克刚
符兆胤
HUANG Wujun;GUO Lijie;HUANG Zhiwei;LI Renwen;HUANG Kegang;FU Zhaoyin(Department of Critical Care Medicine,The First People's Hospital of Qinzhou,Qinzhou 535000,China;Department of Nephrology,The First People's Hospital of Qinzhou,Qinzhou 535000,China)
出处
《现代医学》
2020年第1期65-70,共6页
Modern Medical Journal
基金
钦州市科学研究与技术开发计划(201614505).
关键词
连续性
间歇性
肾脏替代治疗
多器官功能障碍综合征
临床疗效
continuity
intermittent
renal replacement therapy
multiple organ dysfunction syndrome
clinical efficacy