早期连续性血液净化治疗重症脓毒血症急性肾损伤患者的有效性及安全性分析

Effect and Safety Analysis of Early Continuous Blood Purification in Treatment of Severe Sepsis Patients with Acute Kidney Injury

目的探讨早期连续性血液净化治疗重症脓毒血症急性肾损伤患者的有效性及安全性。方法选取2019年1月-2021年12月收治的重症脓毒血症急性肾损伤患者56例为研究对象,将患者随机分为研究组和对照组,分别采用常规治疗(对照组)和联合连续性血液净化治疗(研究组),对比两组患者治疗前后平均动脉压(MAP)、呼吸频率(RR)及心率(HR)、降钙素原(PCT)、C反应蛋白(CRP)及血乳酸(Lac)水平,比较两组患者治疗后肾功能恢复时间和ICU住院时间,随访两组患者12个月内病死率。结果治疗后,两组患者MAP、RR、HR均有明显改善,但研究组患者改善程度更加明显(P<0.05)。两组患者PCT、CRP、Lac水平均有明显改善,且研究组明显低于对照组(P<0.05)。研究组肾功能恢复时间、ICU住院时间均明显短于对照组(P<0.05),研究组病死率低于对照组(P<0.05)。结论采用早期连续性血液净化与常规治疗联合对重症脓毒血症急性肾损伤患者均具有十分显著的价值和意义,并且疗效显著,安全性高,能够大大挽救患者的生命安全,适合在临床上进行实施和开展。

Objective To investigate effect and safety of early continuous blood purification in treatment of severe sepsis patients with acute kidney injury.Methods The paper chose 56 patients with severe sepsis acute kidney injury admitted to our hospital from January 2019 to December 2021,and divided them into study group and control group randomly,with routine treatment(control group)and combined continuous blood purification treatment(study group)respectively.Mean arterial pressure(MAP),respiratory rate(RR),heart rate(HR),pro Calcitonin(PCT)C-reactive protein(CRP)and blood lactate(Lac)levels were compared between two groups in terms of renal function recovery time and ICU length of stay after treatment.Mortality rate within 12 months was followed up between two groups.Results after treatment,both groups showed significant improvements in MAP,RR,and HR,improvement degree in study group was more significant(P<0.05).Levels of PCT,CRP and Lac in both groups were significantly improved,those of study group were significantly lower than control group(P<0.05).Recovery time of renal function and ICU hospitalization in study group was significantly shorter than control group(P<0.05).Mortality rate in study group was 3.57%,lower than 21.43%in control group(P<0.05).Conclusion Combination of early continuous blood purification and routine treatment can achieve significant value and significance for severe sepsis patients with acute kidney injury,with significant effect and high safety,can save lives of patients,which is suitable for clinical practice and development.