早期连续性肾脏替代治疗在严重创伤治疗中的价值

The Value of Early Continuous Renal Replacement Therapy in the Treatment of Severe Trauma

目的:探讨连续性肾脏替代治疗(CRRT)在严重创伤治疗中的价值。方法:回顾性研究2010年1月至2016年11月联勤保障部队第909医院重症医学科的严重创伤合并急性肾损伤(AKI)患者48例,早期行CRRT的26例为观察组,使用常规对症治疗、按指征行CRRT治疗的22例为对照组。结果:观察组血管活性药物使用率、急性呼吸窘迫综合征(ARDS)发生率、CRRT时间低于对照组,观察组24 h乳酸清除率(LCR)高于对照组,差异具有统计学意义(P<0.05)。结论:严重创伤合并AKI的患者早期行CRRT能尽快纠正凝血功能,缩短CRRT疗程及住院时间。

Objective To explore the value of CRRT in the treatment of severe trauma.Methods A retrospective study of 48 patients with severe trauma and acute kidney injury in the Department of Critical Care Medicine of the 909th Hospital of the Joint Logistics Force from January 2010 to November 2016.26 patients who underwent early CRRT were the observation group.They were treated with conventional symptomatic treatment and performed as indicated.22 cases treated with CRRT served as the control group.Results The use rate of vasoactive drugs,the incidence of ARDS,and the CRRT time in the observation group were lower than those in the control group(P<0.05).The 24-hour LCR of the observation group was higher than that in the control group(P<0.05).Conclusion Early CRRT for patients with severe trauma can correct blood coagulation function as soon as possible and shorten the course of CRRT and the length of hospital stay.