血液透析结合血液灌流治疗急性肾功能衰竭疗效及实施价值研究

Therapeutic Effect and Implementation Value of Hemodialysis Combined with Hemoperfusion in the Treatment of Acute Renal Failure

目的探讨血液透析(HD)+血液灌流(HP)对急性肾功能衰竭(ARF)患者的疗效及价值。方法便利选择2018年1月—2021年8月接诊的68例ARF患者,随机分为观察组(纳入34例,行HD+HP)、对照组(纳入34例,行HD)。评价组间肾功能指标[肌酐清除率(Ccr)、血肌酐(Scr)、尿素氮(BUN)]、炎症因子水平[超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)]、治疗相关参数、不良反应发生情况、并发症发生率、临床有效率。结果①治疗前,组间肾功能指标(Ccr、Scr、BUN)、炎症因子水平(hs-CRP、TNF-α、IL-1β)对比,差异无统计学意义(P>0.05);治疗后,观察组上述指标更佳,差异有统计学意义(P<0.05);②较之对照组,观察组治疗相关参数(肾功能恢复时间、平均透析次数、住院时间、脱离透析时间)更佳,差异有统计学意义(P<0.05);③在不良反应发生情况方面,观察组(14.71%)与对照组(17.65%)对比,差异无统计学意义(P>0.05);④观察组并发症发生率(14.71%)低于对照组(44.12%),且临床有效率(94.12%)高于对照组(70.59%),差异有统计学意义(χ^(2)=7.083、6.476,P=0.008、0.011)。结论对ARF患者行HD+HP,能够增强疗效,尽快减轻炎症状态,改善肾功能,缩短恢复时间,加之安全性高,并发症少,值得推广。

Objective To investigate the efficacy and value of hemodialysis(HD)+hemoperfusion(HP)in patients with acute renal failure(ARF).Methods A total of 68 patients with ARF who were admitted from January 2018 to August 2021 were conveniently selected and randomly divided into observation group(34 cases included,HD+HP)and control group(34 cases included,HD),evaluation group Interrenal function indexes[creatinine clearance rate(Ccr),serum creatinine(Scr),blood urea nitrogen(BUN)],inflammatory factor levels[high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),Interleukin-1β(IL-1β)],treatment-related parameters,the occurrence of adverse reactions,complication rates,and clinical efficacy.Results 1.Before treatment,there was no significant difference in renal function indexes(Ccr,Scr,BUN)and inflammatory factor levels(hs-CRP,TNF-α,IL-1β)between the groups,the difference was not statistically significant(P>0.05).After treatment,the above indexes in the observation group were better,the difference was statistically significant(P<0.05).2.Compared with the control group,the treatment-related parameters(recovery time of renal function,average dialysis times,hospitalization time,and weaning time from dialysis)in the observation group were better,the difference was statistically significant(P<0.05).3.In terms of the occurrence of adverse reactions,there was no statistically significant difference between the observation group(14.71%)and the control group(17.65%)(P>0.05).4.The incidence of complications in the observation group(14.71%)was lower than that in the control group(44.12%),and the clinical effective rate(94.12%)was higher than that in the control group(70.59%),the difference was statistically significant(χ^(2)=7.083,6.476,P=0.008,0.011).Conclusion HD+HP for ARF patients can enhance the curative effect,reduce the inflammatory state as soon as possible,improve renal function,shorten the recovery time,and has high safety and few complications,which is worthy of promotion.