连续性肾脏替代治疗对ICU脓毒症患者的临床研究进展

Research progress of continuous renal replacement therapy in ICU sepsis patients

脓毒症是临床上较为危重的疾病之一,与脓毒症相关的感染性休克以及引起多器官功能衰竭(MODS)是脓毒症患者死亡的主要原因。虽然近年来医学技术不断进步,但ICU脓毒症患者感染性休克和MODS死亡率仍然较高,已引起专家学者的关注和重视。血液透析是既往治疗脓毒症的主要方式,但长期治疗容易导致患者出现高血压等并发症,严重影响患者生活质量,干扰治疗效果。连续肾脏替代治疗(CRRT)是近年来出现的治疗方式,它可以通过各种滤过、灌流和吸附技术等,在调节体液平衡同时,清除各种代谢产物以及身体产生的各种致病生物分子。本文从CRRT治疗脓毒症的研究进行综述,分析CRRT治疗脓毒症的机制,进一步探究CRRT在治疗脓毒症中的应用前景,为临床治疗脓毒症提供理论依据。

In recent years, the medical level and the medical procedures are increasingly developed. The multiple organ failure is the major death causes in critically ill patients. In order to discuss the clinical application of the continuous renal replacement therapy（CRRT） in ICU sepsis patients, some scholars propose the concept of continuous blood purification（CBP） which is the generic terms of the continuous therapy of slowly removing the water and solute. It was reported that one AKI（acute kidney injury） case with the overloading diuretics-resistant fluid was cured by the continuous arteriovenous hemofiltration（CAVH）. The CRRT can adjust the isohydria and remove the pathogenic molecular of being caused by the metabolites and the body through the filtration, perfusion, adsorption and other techniques.