脓毒症急性肾损伤患者应用间断血液透析联合乌司他丁治疗的临床观察

Clinical observation of intermittent hemodialysis in combination with ulinastatin in the treatment of sepsis patients with acute kidney injury

目的 探讨对脓毒症急性肾损伤(S-AKI)患者应用间断血液透析(IHD)联合乌司他丁治疗的临床效果,以期为临床相关治疗提供参考。方法 选取河南科技大学第一附属医院2015年6月—2020年6月收治的55例S-AKI患者为研究对象。采用随机数字表法将患者分为观察组(n=27)与对照组(n=28)。对照组患者采用血液透析仪行IHD治疗,观察组患者采用IHD联合乌司他丁治疗。比较2组患者ICU入住时间、机械通气时间以及治疗期间死亡人数。比较2组患者治疗前以及治疗后1个月血肌酐(Scr)、尿素氮(BUN)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、超敏C反应蛋白(hs-CRP)水平。结果 观察组患者ICU入住时间、机械通气时间均短于对照组,差异均有统计学意义(P<0.05)。2组患者病死率比较,差异无统计学意义(P>0.05)。治疗前,2组患者IL-6、IL-8、hs-CRP、Scr、BUN水平比较,差异无统计学意义(P>0.05)。治疗后1个月,2组患者IL-6、IL-8、hs-CRP、Scr、BUN水平均低于治疗前,且观察组低于对照组,差异均有统计学意义(P<0.05)。结论 IHD联合乌司他丁治疗S-AKI的效果确切,可有效改善患者的免疫功能以及肾功能,促进患者康复,改善患者预后,值得临床推广应用。

Objective To investigate the clinical effect of intermittent hemodialysis(IHD)combined with ulinastatin in the treatment of septic patients with acute kidney injury(S-AKI)to provide guidance for clinical treatment.Methods A total of 55 patients with S-AKI admitted to the First Affiliated Hospital of Henan University of Science and Technology from June 2015 to June 2020 were selected as the study subjects.The participants were allocated into an observation group(n=27)and a control group(n=28)by a random number table.Patients in the control group received IHD via a hemodialysis machine,and patients in the observation group received IHD in combination with ulinastatin.ICU length of stay,duration of device ventilation,and the number of on-treatment deaths were compared between the 2 groups.Serum creatinine(Scr),blood urea nitrogen(BUN),interleukin-6(IL-6),interleukin-8(IL-8),and high-sensitivity C-reactive protein(hs-CRP)levels were compared between the 2 groups before treatment and 1 month after treatment.Results The ICU admission time and device ventilation time in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in mortality between the 2 groups(P>0.05).Before treatment,there were no significant differences in IL-6,IL-8,hs-CRP,Scr,and BUN levels between the 2 groups(P>0.05).One month after treatment,the levels of IL-6,IL-8,hs-CRP,Scr and BUN in the two groups were lower than those before treatment,and the observation group was lower than the control group,with statistically significant differences(P<0.05).Conclusion IHD in combination with ulinastatin shows established effects in the treatment of S-AKI.It can effectively enhance the immune function and renal function,promote rehabilitation,and improve the prognosis of patients.These benefits hold promise for a wider application of this technique clinically.