持续性血液透析治疗感染性休克致急性肾损伤患者的效果

Effect of Continuous Renal Replacement Therapy on Patients with Acute Kidney Injury Caused bySeptic Shock

目的:探讨持续性血液透析(continuous renal replacement therapy,CRRT)治疗感染性休克致急性肾损伤患者的效果。方法:选取本院2018年6月-2019年6月重症医学科收治的82例感染性休克致急性肾损伤患者为研究对象。根据随机数字表法分为对照组与观察组,每组41例。对照组进行间歇性血液透析(intermittent hemodialysis,IHD)治疗,观察组进行CRRT治疗,比较两组治疗前后肾功能指标、炎症因子、病情严重程度和院内死亡情况。结果:治疗后,观察组血尿素氮和血肌酐水平均低于对照组(P<0.05);治疗后,观察组白细胞计数(WBC)、C-反应蛋白(C-reactive protein,CRP)、白细胞介素-6(interleukin-6,IL-6)和肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平均低于对照组(P<0.05)。治疗后,观察组急性生理与慢性健康评分表(APACHEⅡ)和序贯器官衰竭评分(SOFA)评分均低于对照组(P<0.05)。观察组院内病死率低于对照组(P<0.05)。结论:CRRT治疗感染性休克致急性肾损伤患者的效果优于IHD,可显著改善患者肾脏功能,抑制炎症反应,提高患者的生存率,值得临床推广。

Objective:To investigate the effect of continuous renal replacement therapy(CRRT)on patients with acute kidney injury caused by septic shock.Method:A total of 82 patients with acute kidney injury caused by septic shock admitted to department of critical care medicine in our hospital from June 2018 to June 2019 were selected as study subjects.According to the random number table method,they were divided into control group and observation group,41 cases in each group.The control group treated with intermittent hemodialysis(IHD),while the observation group treated with CRRT.Renal function indexes,inflammatory factors,disease severity and in-hospital death were compared between the two groups before and after treatment.Result:After treatment,blood urea nitrogen and creatinine levels in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of white blood cell count(WBC),C-reactive protein(CRP),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)in the observation group were lower than those in the control group(P<0.05).After treatment,acute physiology and chronic health assessment(APACHEⅡ)and sequential organ failure score(SOFA)score of the observation group were lower than those of control group(P<0.05).The nosocomial mortality of the observation group was lower than that of the control group(P<0.05).Conclusion:CRRT is superior to IHD in the treatment of acute kidney injury caused by septic shock.It can significantly improve the kidney function of patients,inhibit inflammatory response,and improve the survival rate of patients,which is worthy of clinical promotion.