持续血液滤过治疗脓毒血症并急性肾衰竭的临床价值研究

Clinical Value of Continuous Hemofiltration in the Treatment of Sepsis and Acute Renal Failure

目的观察持续血液滤过治疗脓毒血症并急性肾衰竭的临床价值。方法将2018年1—12月60例在该院接受治疗的脓毒血症并急性肾衰竭患者纳入研究对象,遵循随机原则将患者分为观察组(30例)与对照组(30例),分别给予静脉持续血液滤过治疗与静脉血液透析治疗,对两组患者治疗前后各项生化指标及APACHEII评分、血清炎性指标以及临床治疗效果进行综合评价。结果观察组患者治疗后肉毒素、C反应蛋白、Cr等指标分别为(13.29±6.52)pg/mL、(0.48±0.31)mg/dL、(132.16±70.39)μmol/L,均明显改善,与对照组比较差异有统计学意义(t=13.494、6.804、8.952,P<0.05);两组患者治疗后IL-6、TNF-a指标比较观察组优于对照组(31.52±12.35)ng/Lvs(45.41±13.34)ng/L、(34.28±12.41)ng/Lvs(40.21±14.24)ng/L,差异有统计学意义(t=13.630,7.804,P<0.05);观察组患者治疗后总有效率达到93.3%,与对照组的70.0%,差异有统计学意义(χ^2=10.264,P<0.05)。结论持续血液滤过治疗脓毒血症并急性肾衰竭,能够促进患者肾功能恢复,增强预后,效果显著,值得推广应用。

Objective To observe the clinical value of continuous hemofiltration in the treatment of sepsis and acute renal failure. Methods Sixty patients with sepsis and acute renal failure who were treated in our hospital from January to December 2018 were enrolled in the study. The patients were divided into observation group (30 cases) and control group (30 cases) according to random principle, were given intravenous continuous hemofiltration and venous hemodialysis respectively. The biochemical parameters, APACHE II score, serum inflammatory index and clinical treatment effect were evaluated before and after treatment. Results The indexes of endotoxin, C-reactive protein and Cr in the observation group were (13.29±6.52)pg/mL,(0.48±0.31)mg/dL,(132.16±70.39)μmol/L, respectively. The difference was statistically significant compared with the control group(t=13.494,6.804,8.952, P<0.05). The IL-6 and TNF-a indicators in the two groups were better than the control group (31.52±12.35)ng/L vs(45.41±13.34)ng/L,(34.28±12.41)ng/L vs (40.21±14.24)ng/L, statistically significant (t=13.630,7.804, P<0.05);patients in the observation group always had efficiency reached 93.3% after treatment, which was statistically different from the control group of 70.0%(χ^2 =10.264, P< 0.05). Conclusion Continuous hemofiltration in the treatment of sepsis and acute renal failure can promote the recovery of renal function and enhance the prognosis of patients with significant results, which is worthy of popularization and application.