重症肺部感染患者应用连续性肾替代治疗的疗效

Efficacy analysis of continuous renal replacement therapy on patients with severe pulmonary infection

目的：分析重症肺部感染患者应用连续性肾替代治疗的作用及效果。方法：以武汉大学人民医院2014年5月～2015年5月收治的重症肺部感染患者50例为研究对象，给予患者连续性肾替代治疗，观察和分析治疗前后患者的临床症状变化、急性生理与慢性健康（APACHE）Ⅱ评分、血常规、血气指标、肾功能（尿素、肌酐、尿酸）、电解质（血钾、血钠）变化及治疗成功率。结果：患者经连续性肾替代治疗后，47例患者的呼吸困难症状明显减轻，体温均有一定程度的下降；治疗后患者的电解质、APACHEⅡ评分和肾功能较治疗前均有明显改善（P〈0．01）；血常规和血气分析各项指标较治疗前均有明显改善（P〈0．01）。救治成功患者36例，死亡14例，结论：危重症感染应用连续性肾替代治疗，具有良好的效果，能有效改善患者的电解质、APACHEH评分及肾功能，是一种有效的辅助治疗措施。

Objective： To analyze the efficacy of continuous renal replacement therapy on patients with severe pulmonary infection. Method： A total of 50 patients with severe pulmonary infection treated in our hospital from May 2014 to May 2015 were selected and treated with continuous renal replacement therapy. Clinical symptoms, acute physiology and chronic health evaluation（APACHE） Ⅱ, blood routine and blood gas indexes, renal function（urea, creatinine, uric acid） and electrolyte（ blood potassium, blood sodium） changes and success rate of treatment were observed and analyzed before and after treatment. Results： After continuous renal replacement therapy, dyspnea was obviously relieved for 47 cases of patients. Temperature was decreased accordingly. After treatment, electrolyte, APACHE Ⅱand renal function of patients were obviously improved （P〈 0.01） blood routine and blood gas indexes were obviously improved （P〈0.01）. 36 cases were successfully saved, 14 died. Conclusion： Continuous renal replacement therapy shows better efficacy and could effectively improve the electrolyte, A- PACHEⅡ and renal function for patients with severe pulmonary infection.