连续性静脉-静脉血液滤过治疗肾功能衰竭伴多脏器功能障碍综合征的疗效

Effect of continuous veno venous hemofiltration on renal failure complicated with multiple organ dysfunction syndrome

目的探究连续性静脉-静脉血液滤过(CRRT)治疗肾功能衰竭合并多脏器功能障碍综合征患者的疗效。方法选取2017年2月至2020年1月本院收治的肾功能衰竭合并多脏器功能障碍综合征患者35例,所有患者均接受原发病治疗、营养支持等常规治疗及CRRT治疗,比较治疗前后患者血生化指标、肾功能指标、IL-6、IL-8、TNF-α、APACHEⅡ评分、Marshall评分,分析临床转归。结果治疗前后,患者Na;、Cl;水平比较差异无统计学意义;治疗后,患者SaO;、MAP、PO;/FiO;水平均高于治疗前,差异有统计学意义;HR、CVP、K;、BUN、SCr及乳酸水平均低于治疗前,差异有统计学意义(P<0.05)。治疗后,患者IL-6、IL-8、TNF-α及CRP水平均明显低于治疗前,差异有统计学意义(P<0.05)。治疗后,患者APACHEⅡ及Marshall评分均低于治疗前,差异有统计学意义(P<0.05)。存活患者25例,存活率71.43%。结论CRRT治疗肾功能衰竭合并多脏器功能障碍综合征患者效果显著,能明显改善器官组织功能,提高生存率。

Objective To investigate the effect of continuous veno venous hemofiltration (CRRT) on patients with renal failure complicated with multiple organ dysfunction syndrome.Methods 35 patients with renal failure complicated with multiple organ dysfunction syndrome admitted to our hospital from February 2017 to January 2020 were selected.All patients received routine treatment such as primary disease treatment,nutritional support and CRRT,the blood biochemical indexes,renal function indexes,IL-6,IL-8,TNF-α,APACHE II scores,and Marshall scores were compared before and after treatment,and the clinical outcomes were analyzed.Results There was no significant difference in the levels of Na;and Cl;before and after treatment;after treatment,the levels of SaO;and MAP,PO;/FiO;were significantly higher than those before treatment;the levels of HR,CVP,K;,bun,SCr,lactic acid were lower than those before treatment (P<0.05).After treatment,IL-6,IL-8 and TNF-αand CRP levels were significantly lower than those before treatment (P<0.05).After treatment,APACHEⅡand Marshall scores were lower than those before treatment (P<0.05).25patients survived,and the survival rate was 71.43%.Conclusion CRRT is effective in the treatment of patients with renal failure complicated with multiple organ dysfunction syndrome,which can significantly improve the function of organs and tissues and improve the survival rate.