不同持续性肾脏替代疗法治疗剂量对感染性休克患者临床疗效观察

Clinical Observation of Different Doses of Continuous Renal Replacement Therapy in Patients with Septic Shock

目的探讨在感染性休克抢救治疗中,对比不同剂量持续性肾脏替代疗法(CRRT)的临床效果。方法选取我院ICU接诊84例感染性休克患者,随机分为A组、B组、C组,各组28例,CRRT治疗剂量分别为25m L/(kg.h)、35m L/(kg.h)、45m L/(kg.h),观察三组丙二醛(MDA)、髓化过氧化物酶(MPO)以及C反应蛋白(CRP)三相应激反应指标变化以及治疗3d、7d的病死率进行统计。结果三组治疗后MDA、MPO、CRP水平较治疗前有显著下降,其中C组MDA、MPO、CRP水平显著低于B组,B组MDA、MPO、CRP水平显著低于A组(P<0.05);A组治疗7d病死率为35.71%,B组治疗7d病死率为21.43%,C组治疗7d病死率为7.14%,(P<0.05)。结论大剂量CRRT治疗能够更好的改善感染性休克患者的应激反应水平,控制病死率。

Objective To explore the clinical effect of continuous renal replacement therapy（CRRT） with different doses in the treatment of septic shock. Methods 84 cases of septic shock were selected from ICU in our hospital. The patients were randomly divided into group A, group B and group C, with 28 cases in each group. The dosage of CRRT was 25 m L/（kg.h）, 35 m L/（kg.h）, 45 m L/（kg.h）, and three groups of malondialdehyde（MDA）, myelinated peroxidase and reactive protein were observed. The change of standard and the mortality of 3 D and 7 d were statistically analyzed. Results The levels of MDA, MPO and CRP in the three groups were significantly lower than those before the treatment, and the levels of MDA, MPO and CRP in the group C were significantly lower than those in the B group. The MDA, MPO and CRP levels in the group B were significantly lower than those in the group, and the fatality rate of the group was 35.71%, and the fatality rate was 21.43%. Conclusion High dose CRRT treatment can better improve the stress response level and control the mortality of patients with septic shock.