不同液体复苏策略对AKI患者肾功能的影响

Effect of Different Liquid Resuscitation Strategies on Renal Function of Septic Shock AKI Patients

探讨脉搏指示连续心排血量监测(pulse-indicated continuous cardiac output,PiCCO)与连续肾脏替代疗法(continous renal replacement therapy,CRRT)的液体复苏策略对脓毒性休克急性肾损伤(acute kidney injury,AKI)患者肾功能的临床疗效。选取80例AKI患者,根据液体复苏策略不同,将其分为PiCCO液体复苏组和CRRT液体复苏组,每组各40例。以两组患者复苏后的液体平衡量、尿量变化、中心静脉压(central venouspressure,CVP)、肾功能恢复率和平均住院时间为评价指标,分析两种不同液体复苏策略对AKI患者肾功能的临床治疗效果。结果表明,PiCCO液体复苏组患者的液体平衡量(2767.0±630.0 ml)、CVP(4.6±1.4 mmHg)和平均住院时间(13.45±3.55 d)显著少于CRRT液体复苏组患者(P<0.05),尿量变化(1.31±0.22 mL/kg/h)和肾功能恢复率(87.6%)显著增加,差异均有统计学意义(P<0.05)。对AKI患者采用PiCCO的液体复苏策略,可以显著降低患者肾脏的液体负荷,提高肾功能恢复率,改善AKI患者的临床症状。

The research explores the clinical effect of pulse-indicated continuous cardiac output(PiCCO)and continous renal replacement therapy(CRRT)liquid resuscitation strategies on the renal function of patients with acute kidney injury(AKI).80 patients with septic shock AKI patients are selected,and they are divided into PiCCO liquid resuscitation group and CRRT fluid resuscitation group according to different resuscitation strategies,with 40 patients in each group.Liquid equilibrium amount,urine volume,central venouspressure(CVP),renal function recovery rate and average hospitalization time of two groups after recovery are selected as the evaluation index.Clinical treatment effects of two different liquid equilibrium strategies on renal function of AKI patients are analyzed.The results show that patient’s liquid equilibrium amount,CVP,and average hospitalization time of PiCCO liquid resuscitation group are(2767.0±630.0)ml,(4.6±1.4)mmHg and(13.45±3.55)d,which are significantly less than patients of CRRT liquid resuscitation group(P<0.05).And urine volume change(1.31±0.22)mL/kg/h and renal functional recovery rate(87.6%)increases significantly,with statistically significant difference(P<0.05).Liquid resuscitation strategies of PiCCO on septic shock AKI patients can significantly reduce the renal liquid load of patients,improve renal function recovery rate,and improve the clinical symptom of septic shock AKI patients.