连续性肾脏替代治疗感染性急性肾损伤的效果观察

Effect observation of continuous renal replacement therapy in infectious acute kidney injury

目的探讨连续性肾脏替代治疗感染性急性肾损伤的临床效果。方法收集本院连续性肾脏替代治疗感染性急性肾损伤的患者42例,根据急性肾损伤的不同分期,分为急性肾损伤Ⅰ组(18例)、Ⅱ组(13例)、Ⅲ组(11例),APACHEⅡ评分比较预后恢复情况,并分析影响肾功能恢复的因素。结果急性肾损伤Ⅰ、Ⅱ组治疗48 h后的APACHEⅡ评分明显低于治疗前,差异有统计学意义(P<0.05);急性肾损伤Ⅲ组治疗前、治疗48 h后APACHEⅡ评分差异无统计学意义(P>0.05)。肾功能恢复率与人为选择的影响因素不存在线性相关性(P>0.05)。结论连续性肾脏替代治疗在急性肾损伤Ⅰ、Ⅱ期时可明显改善感染患者的肾功能恢复情况,而在急性肾损伤Ⅲ期则对患者预后影响不大。

Objective To investigate the clinical efficacy of continuous renal replacement therapy in infectious acute kidney injury. Methods 42 cases of patients with infectious acute kidney injury in our hospital were selected,and were divided into acute kidney injury Ⅰ group （18 cases）,Ⅱ group （13 cases）,Ⅲ group （11 cases） according to the different stages,APACHEII scores was used to evaluate the prognosis recovery,factors that affect the recovery of kidney function were analyzed. Results APACHEII scores ofⅠ group andII group after 48-hour treatment were lower than those before treatment （P〈0.05）,APACHEII scores of Ⅲ group before and after treatment had no significant difference （P〉0.05）.There was no linear correlation about the recovery rate of kidney function with artificial selection factors （P〉0.05）. Conclusion Continuous renal replacement therapy in acute kidney injury Ⅰ and Ⅱ can significantly improve the kidney function in patients with infection,while has little effect on prognosis of acute kidney injuryⅢ.