持续低效血液透析联合血流灌注治疗脓毒症所致急性肾损伤患者的疗效

Efficacy of Continuous Low-efficiency Hemodialysis Combined with Blood Perfusion in the Treatment of Sepsis-induced Acute Kidney Injury

目的 探讨持续低效血液透析联合血流灌注治疗脓毒症所致急性肾损伤患者的疗效.方法 选取2016年5月至2018年8月在医院接受治疗的脓毒症所致急性肾损伤患者88例,按照随机数字表法分为试验组和对照组,每组44例.两组均先接受常规综合治疗,在此基础上,对照组实施连续性肾脏替代治疗,试验组实施持续低效血液透析联合血流灌注治疗,比较两组健康状况、 生命体征、 肾功能、 炎性细胞因子、 并发症及30 d病死率.结果 治疗后试验组急性生理和慢性健康状况评估系统Ⅱ(APACHEⅡ)评分、 心率(HR)、 超敏C反应蛋白(hs-CRP)、 白细胞介素-6(IL-6)、 白细胞介素-10(IL-10)、 肿瘤坏死因子α(TNF-α)、血肌酐(SCr)、 尿素氮(BUN)水平均低于对照组,平均动脉压(MAP)、 尿量、 α1-微球蛋白(α1-MG)水平均高于对照组,差异有统计学意义(P<0.05);试验组并发症发生率(6.82%)低于对照组(25.00%),30 d病死率(11.36%)低于对照组(29.55%),差异有统计学意义(P<0.05).结论 持续低效血液透析联合血流灌注治疗脓毒症所致急性肾损伤患者的疗效明显,可改善患者肾功能,阻止肾损伤恶化,减轻炎症反应.

Objective To investigate the efficacy of continuous inefficient hemodialysis combined with blood perfusion in the treatment of acute kidney injury caused by sepsis.Methods Eighty-eight patients with acute kidney injury caused by sepsis who were treated in the hospital from May 2016 to August 2018 were randomly divided into experimental group and control group,with 44 cases in each group.Both groups received conventional comprehensive treatment,the control group received continuous renal replacement therapy,and the experimental group received continuous inefficient hemodialysis combined with perfusion.After treatment,the health status,vital signs,renal function,inflammatory cytokines,complications and 30-day mortality were compared between the two groups.Results The health status assessment Ⅱ score,heart rate,hs-CRP,IL-6,IL-10,TNF-α,SCr,BUN levels in the experimental group were lower than those in the control group,mean arterial pressure,urine output,α1-MG levels were higher than the control group,the difference was statistically significant(P<0.05);the incidence of complications in the experimental group(6.82%) was lower than that in the control group(25.00%),and the mortality rate of 30 days(11.36%) was lower than that in the control group(29.55%),the difference was statistically significant(P<0.05).Conclusions Continuous inefficient hemodialysis combined with perfusion is better for acute kidney injury caused by sepsis.It can improve renal function,prevent renal injury and reduce inflammation.