肾脏替代治疗时间对重症急性肾衰竭患者预后的影响

Effect of renal replacement therapy time on the prognosis of patients with severe acute renal failure

目的探讨对重症急性肾衰竭患者采用不同的肾脏替代时间产生的预后效果。方法选取2013年2月~2015年2月我院收治的120例重症急性肾衰竭患者作为研究对象,其中60例患者的肾脏替代治疗时间>12 h,将其设为长时组,60例患者的肾脏替代治疗时间在6~12 h以内,将其设为短时组。分别观察两组患者的治疗效果以及预后情况。结果对两组患者治疗前后的BUN、SCr、APACHEⅡ评分以及HR、MAP、Na^+、HCO_3^-、K^+进行比较,仅治疗后长时组的BUN、SCr、Na^+、HCO_3^-手旨标与短时组相比差异具有统计学意义(P<0.05),其他情况下比较差异均无统计学意义(P>0.05)。长时组死亡17例(28.3%)与短时组死亡19例(31.7%)差异无统计学意义(x^2=0.159,P>0.05)。结论不同的肾脏替代治疗时间对重症急性肾衰竭患者的预后效果无太大影响,但在早期及时进行治疗对患者的预后有一定的影响。

Objective To explore the prognosis effect of different renal replacement time on the patients with severe acute renal failure. Methods A total of 120 patients with severe acute renal failure who were admitted to our hospital from February 2013 to February 2015 were selected as the research subjects. Among them, the renal replacement therapy time of 60 patients was longer than 12 h, and they were assigned to the long time group. 60 patients with 6-12 h renal replacement therapy time were assigned to the short time group. Curative effects and prognosis were observed in the two groups of patients. Results BUN, SCr, APACHE Ⅱ score and HR, MAP, Na^＋, HCO3^-, K^＋ before and after the treatment in the two groups of patients were compared. Only BUN, SCr, Na^＋, HCO3^- in the long time group after the treatment were significantly different compared with those in the short time group, and the differences were statistically significant （P〈0.05）. There was no statistical significant in the comparison of other conditions （P〉0.05）. Death was observed in 17 patients （28.3%） in the long time group, and there was not significantly different compared to 19 dead patients （31.7%） in the short time group. The comparison was not statistically significant（χ^2=0.159, P〉0.05）. Conclusion The effect of different renal replacement therapy time is not significant on the prognosis of severe acute renal failure. However, early and timely treatment has certain effects on patients＇ prognosis.