连续性肾脏替代治疗时机对脓毒性休克伴急性肾损伤患者预后的影响

Impact of timing of initiating continuous renal replacement therapy on prognosis of patient with septic shock and acute renal injury

目的:探讨连续性肾脏替代治疗不同时机对脓毒性休克伴有急性肾损伤患者预后的影响方法:回顾分析2015年5月31日〜2018年5刀31日北京市顺义区医院ICLJ收治的54例诊断为感染性休克合并急性肾损伤、接受连续性肾脏替代治疗(CKRT)患者的临床资料按照脓毒症3.0诊断标准及改善全球肾病预后组织的急性肾损伤分级标准,将患者分为早期CRRT组(n=29)和延迟CKKT组(n=25),比较2组患者90 d死亡率,分析脓毒性休克合并急性肾损伤患者90 d预后的影响因素结果:54例患者90 d病死率55.6%,多因素分析发现,延迟CRRT、APACHEI1评分升高是脓毒性休克合并急性肾损伤患者90 d内死亡的独立危险因素:结论:早期肾脏替代治疗可改善脓毒症合并急性肾损伤患者预后。

Objective:To investigate the influence of timing of initiating continuous renal replacement therapy(CRRT)on the prognosis of septic shock patients with acute renal injury.Methods:The clinical data of 54 patients diagnosed with septic shock combined with acute renal injun and received CRRT in ICU of Beijing Shunyi District Hospital were collected.According to the diagnostic criteria of Sepsis 3.0 and Kidney Disease:Improving Global Outcomes,the patients were divided into early CRRT group(n=29)and delayed CRRT group(n=25).The 90-day mortality was compared between the two groups,and the factors affecting the 90-day prognosis of patients with septic shock and acute kidney injury were analyzed retrospectively.ResuIts:The 90-day mortality of all the 54 patients was 55.6%.Multivariate analysis showed that delayed CRRT and higher APACHE II(Acute Physiology and Chronic Health Evaluation II)scores were independent risk factors for 90-day mortality with septic shock and acute renal injury.Conclusion:Early initiation of CRRT could improve the prognosis of patients with sepsis combined with acute renal injury.