早期连续性血液净化治疗胃癌术后并发急性肾损伤的临床效果观察

Clinical Observation of Early Continuous Blood Purification Treatment for Gastric Cancer Complicated with Acute Kidney Injury After Operation

目的探讨早期连续性血液净化(CBP)治疗胃癌术后并发急性肾损伤(AKI)的临床效果。方法按照随机数字表法将郑州大学第一附属医院2021年2月至2023年12月期间收治的胃癌术后并发AKI患者60例分为研究组(n=30)与参考组(n=30),前者行早期CBP治疗,后者行传统CBP治疗。对比2组炎症指标、肾功能指标、病情严重程度、住院时间。结果治疗后2组白介素-6(IL-6)、白介素-8(IL-8)、C反应蛋白(CRP)水平均低于治疗前,而研究组各项指标水平低于参考组(P<0.05)。治疗后2组肝型脂肪酸结合蛋白(L-FABP)、尿液中肾损伤分子-1(KIM-1)、尿液中性粒细胞明胶酶相关脂质运载蛋白(NGAL)水平均低于治疗前,而研究组各项指标水平低于参考组(P<0.05)。治疗后2组急性生理学及慢性健康状况评分Ⅱ(APACHEⅡ)评分均低于治疗前,而研究组APACHEⅡ评分低于参考组,且住院时间短于参考组(P<0.05)。结论早期CBP治疗胃癌术后并发AKI可更好地减轻炎症反应,改善肾功能,减轻患者病情,缩短住院时间。

Objective To investigate the clinical effect of early continuous blood purification(CBP)in the treatment of postoperative acute kidney injury(AKI)for gastric cancer.Methods According to random number table method,60 gastric cancer patients with postoperative AKI were divided into the study group(n=30)and reference group(n=30).The former received early CBP treatment,and the latter received traditional CBP treatment.Inflammatory indexes,renal function indexes,severity of disease and length of hospital stay were compared between the 2 groups.Results After treatment,the values of interleukin-6(IL-6),interleukin-8(IL-8)and C-reactive protein(CRP)in the 2 groups were lower than before treatment,while those in the study group were lower than those in the reference group(P<0.05).After treatment,the values of liver fatty acid-binding protein(L-FABP),renal injury molecule 1(KIM-1)and urine neutrophil gelatinase-associated lipid carrier protein(NGAL)in 2 groups were lower than before treatment,while those in the study group were lower than those in the reference group(P<0.05).After treatment,the acute physiology and chronic health status scoreⅡ(APACHEⅡ)scores of the 2 groups were lower than before treatment,while the APACHEⅡscores of the study group were lower than that of the reference group,and the hospital stay was shorter than that of the reference group(P<0.05).Conclusion Early CBP treatment of gastric cancer complicated with AKI can better reduce inflammatory response,improve renal function,alleviate the disease of patients,shorten the length of hospital stay.