CRRT在感染性休克致急性肾功能衰竭中的疗效评价

The efficacy of continuous renal replacement therapy in acute renal failure patients induced by septic shock

目的:观察连续性肾脏替代治疗(CRRT)感染性休克致急性肾功能衰竭的疗效。方法:感染性休克致急性肾功能衰竭患者26例,以行CRRT的患者作为治疗组(10例),同期未行CRRT而行常规治疗的患者作为对照组(16例)。两组均动态观察患者治疗前及治疗后血二氧化碳结合力、尿素氮、肌酐、血钾、血钠、血氯、血乳酸等的变化,并动态监测平均动脉压及尿量,比较两组疗效及生存率。结果:CRRT治疗组病情略重于未行CRRT治疗的对照组,APACHEⅡ评分治疗组为(19.0±2.4)分,对照组为(17.4±2.1)分。CRRT治疗组存活7例(70.00%),死亡3例(30.00%),对照组存活7例(43.75%),死亡9例(56.29%),两组差异显著(P<0.05)。CRRT治疗过程中血流动力学稳定,尿量增多,肾功能及生化指标均较对照组得到较好控制。结论:对于感染性休克致急性肾功能衰竭的患者,行CRRT治疗可提高救治成功率。

Objective： To observe the efficacy of CRRT in patients with acute renal failure induced by septic shock. Methods： 26 patients with acute renal failure induced by septic shock were divided into treatment group of CRRT （10 patients） and control group with routine therapy （16 patients）. The blood carbon dioxide combining power, blood urea nitrogen and creatinine, serum sodium, chlorine and potassium levels, arterial lactic acid level were compared between the two groups before and after treatment. Urine output and mean arterial blood pressure were monitored dynamically during the treatment. The efficacy of treatment and mortality of the two groups were analyzed. Results： The patients in CRRT group were more severe than those in control group. The APACHE Ⅱ score was （19.0±2.4） scores in CRRT group while （17.4± 2.1） scores in control group. But 7 patients in CRRT group survived （70.00%） and 3 patients died （30.00%）, while in control group 7 patients survived （43.75%） and 9 patients died （56.29%）. There was a significant difference between CRRT and control group in the survival rate （P〈0.05）. Compared with the control group, the patients in CRRT group had more urine output, stable hemodynamical indicators and better biochemical results. Conclusion： Early continuous renal replacement treatment for acute renal failure patients induced by septic shock can improve the survival rate.