CRRT治疗对重症急性肾衰竭患儿血流动力学、炎性因子及肾功能的影响

Influence of CRRT on Hemodynamics,Inflammatory Factors and Renal Function in Children with Severe Acute Renal Failure

目的:探讨连续性肾脏替代疗法(CRRT)治疗对重症急性肾衰竭患儿血流动力学、炎性因子及肾功能的影响。方法:选择2019年4月-2020年4月本院治疗的重症急性肾衰竭患儿68例作为研究对象,随机分成对照组和观察组,每组34例。对照组进行常规间歇性血液透析治疗,观察组进行CRRT治疗。比较治疗前后两组肾功能水平、炎性因子、血流动力学水平及并发症发生率。结果:治疗前两组血肌酐(Scr)、尿素氮(BUN)及血尿酸(UA)水平对比差异无统计学意义(P>0.05);治疗后,观察组Scr、BUN、UA水平低于对照组(P<0.05)。治疗前,两组高敏C反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)、IL-6水平比较差异无统计学意义(P>0.05),治疗后,观察组hs-CRP、TNF-α、IL-6水平均低于对照组(P<0.05)。治疗前两组SBP、DBP和HR水平比较差异无统计学意义(P>0.05),治疗后观察组各血流动力学指标水平均低于对照组(P<0.05);治疗后,观察组并发症(低血压、心律失常、低体温、肾功能异常及心脏骤停)总发生率为17.65%,明显低于对照组的44.12%(P<0.05)。结论:CRRT治疗对重症急性肾衰竭患儿效果较好,有效改善患儿的肾功能,降低炎性因子水平,改善血流动力学水平,有效降低治疗后的并发症发生率,值得推广应用。

Objective:To investigate the effect of continuous renal replacement therapy(CRRT)on hemodynamics,inflammatory factors and renal function in children with severe acute renal failure.Method:A total of 68 children with severe acute renal failure who were treated in our hospital from April 2019 to April 2020 were selected as the research objects and randomly divided into the control group and the observation group,with 34 cases in each group.The control group was given conventional intermittent hemodialysis,and the observation group was given CRRT.The levels of renal function,inflammatory factors,hemodynamics and the incidence of complications before and after treatment were compared between the two groups.Result:Before treatment,there were no significant differences in the levels of serum creatinine(Scr),blood urea nitrogen(BUN)and uric acid(UA)in the two groups(P>0.05);after treatment,the levels of Scr,BUN and UA in the observation group were lower than those in the control group(P<0.05).Before treatment,there were no significant differences in the levels of high sensitivity C-reactive protein(hs-CRP),tumor necrosis factorα(TNF-α)and IL-6 in the two groups(P>0.05);after treatment,the levels of hs-CRP,TNF-α,IL-6 in the observation group were lower than those in the control group(P<0.05).Before treatment,there were no significant differences in the SBP,DBP and HR levels of the two groups(P>0.05);after treatment,the hemodynamic indexes of the observation group were lower than those of the control group(P<0.05).The total incidence of complications(hypotension,arrhythmia,hypothermia,renal dysfunction and cardiac arrest)in the observation group was 17.65%,which was significantly lower than 44.12%in the control group(P<0.05).Conclusion:CRRT has a good effect on children with severe acute renal failure,which can effectively improve the renal function,reduce the level of inflammatory factors,improve the level of hemodynamics,and effectively reduce the incidence of complications after treatment,which is worthy of promotion and application.