连续性肾脏替代疗法与间歇性血液透析疗法对于初发尿毒症患者诱导期的临床疗效对比

Comparison on the curative effect of continuous renal replacement therapy and intermittent hemodialysis in the treatment of incipient toxuria

目的研究连续性肾脏替代疗法(CRRT)与间歇性血液透析疗法(HD)在治疗初发尿毒症患者诱导期中的效果。方法在基层医院于2014年2月至2016年8月间收治的初发尿毒症患者中选出93例作为研究对象,将患者随机分入到CRRT组和常规HD组中,观察两组患者入院时、治疗第4 d、7 d时的尿素氮、血肌酐、甲状旁腺激素、血红蛋白等实验室指标值以及APACHEⅢ评分、并发症发生率、住院时间、住院总费用指标值。结果治疗第4 d、7 d,CRRT组患者的BUN、Cr、PTH值、PRO-BNA值、APACHEⅢ评分明显低于常规HD组,且Hb、TUF值明显高于常规HD组,P<0.05;CRRT组患者的不良反应发生率10.64%低于常规HD组的28.26%,P<0.05;CRRT组患者的住院时间更短且住院总费用低,P<0.05。结论连续性肾脏替代疗法在基层医院初发尿毒症患者中治疗效果确切,安全性高,且费用低,值得推广应用。

Objective To study the effect of continuous renal replacement therapy（ CRRT） and intermittent hemodialysis（ HD） in the treatment of incipient toxuria. Methods A total of 93 patients with incipient toxuria admitted to our hospital between February 2014 and August 2016 were selected as the subjects.The patients were randomly divided into CRRT group and conventional HD group. Laboratory indexes including urea nitrogen,serum creatinine and parathyroid hormone of two groups of patients at the time points admitted to hospital,4th and 7th day during treatment and APACHE Ⅲ score,incidence of complications,length of hospital stay,total cost in hospital were observed.Results On the 4-（th） and 7-（th） day during the treatment,BUN,Cr,PTH,PRO-BNA,APACHE score of CRRT group were significantly lower than the conventional HD group,however,Hb and TUF value were significantly higher than the conventional HD group,P 0. 05. The incidence of adverse events in CRRT group was 10. 64% which was lower than 28. 26% of the conventional HD group,P 0. 05. The CRRT group had a shorter hospital stay and a lower total hospitalization cost,P 0.05. Conclusions Continuous renal replacement therapy is effective in the treatment of incipient toxuria in the primary hospital,and it has high safety and low cost,so it is worthy of popularization and application.