连续性高容量血液滤过联合血液灌流治疗脓毒症合并急性肾损伤的效果观察

Effect Observation of Continuous High-Volume Hemofiltration Combined with Hemoperfusion in Treatment of Sepsis Complicated with Acute Kidney Injury

目的:观察连续性高容量血液滤过(CHVHF)联合血液灌流(HP)治疗脓毒症合并急性肾损伤的临床效果。方法:选取2020年1月—2023年6月广西医学科学院·广西壮族自治区人民医院收治的90例脓毒症合并急性肾损伤患者作为研究对象,采用随机数字表法分为新式组与传统组,各45例。两组均接受常规抗脓毒症治疗,传统组在常规抗脓毒症治疗基础上接受CHVHF治疗,新式组在传统组基础上接受HP治疗。比较两组治疗效果。结果:治疗后,两组碱性磷酸酶、肾血流阻力指数水平低于治疗前,且新式组低于传统组,差异有统计学意义(P<0.05)。治疗后,两组彩色多普勒血流成像分级高于治疗前,且新式组高于传统组,差异有统计学意义(P<0.05)。新式组治疗总有效率高于传统组,差异有统计学意义(P<0.001)。治疗后,两组降钙素原、白细胞介素-6、白细胞介素-10、肿瘤坏死因子-α、超敏C反应蛋白水平低于治疗前,且新式组低于传统组,差异有统计学意义(P<0.05)。结论:CHVHF联合HP治疗脓毒症合并急性肾损伤的临床效果显著,可清除血液毒素,改善肾损伤情况及炎性因子水平。

Objective:To observe the clinical effects of continuous high-volume hemofiltration(CHVHF)combined with hemoperfusion(HP)in treatment of sepsis complicated with acute kidney injury.Methods:A total of 90 patients with sepsis complicated with acute kidney injury admitted to Guangxi Academy of Medical Sciences·The People's Hospital of Guangxi Zhuang Autonomous Region from January 2020 to June 2023 were selected as the study subjects.These patients were divided into the new group and the traditional group according to random number table method,with 45 cases in each group.Both groups received conventional antisepsis therapy.The traditional group received CHVHF treatment on the basis of conventional antisepsis therapy,and the new group received HP treatment on the basis of the traditional group.The treatment effects were compared between two groups.Results:After treatment,the levels of alkaline phosphatase and renal blood flow resistance index in the two groups were lower than those before treatment,these levels in the new group were lower than those in the traditional group,and the difference was statistically significant(P<0.05).After treatment,the color Doppler blood flow assessment grade in the two groups was higher than that before treatment,the grade in the new group was higher than that in the traditional group,and the difference was statistically significant(P<0.05).The total effective rate of treatment in the new group was higher than that in the traditional group,and the difference was statistically significant(P<0.001).After treatment,the levels of procalcitonin,interleukin-6,interleukin-10,tumor necrosis factor-αand high-sensitivity C-reactive protein in the two groups were lower than those before treatment,these levels in the new group were lower than those in the traditional group,and the difference was statistically significant(P<0.05).Conclusion:CHVHF combined with HP has significant clinical effect in the treatment of sepsis complicated with acute kidney injury,and can remove blood toxins,improve kidney injury and inflammatory factor levels.