脓毒血症AKI患者采用CRRT治疗的临床疗效  

To investigate the clinical efficacy of sepsis CRRT treatment for patients with AKI

作　　者：曹昉[1] 冷彦飞[1] 严斌[1] 王若霜 李磊[1] 袁飞远[1] 陈晖[1] 鄢成静 安克润[1] 

机构地区：[1]四川省凉山彝族自治州第一人民医院肾病内科,四川西昌615000

出　　处：《临床和实验医学杂志》2015年第14期1196-1198,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的分析脓毒血症急性肾损伤(AKI)患者行连续性肾脏替代治疗(CRRT)的临床疗效。方法选取2012年1月至2014年7月因脓毒血症AKI住院治疗的患者共92例,随机分为实验组和对照组。实验组予以CRRT治疗,对照组予以常规药物治疗。对比两组患者治疗前及治疗3 d后的生命体征、血清学指标、7 d及28 d病死率。结果两组患者治疗3 d后的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、尿量和氧饱和度(Sp O2)均显著高于治疗前(P<0.05);实验组治疗3 d后的SBP、DBP、MAP、尿量和Sp O2均显著高于对照组(P<0.05)。两组患者治疗3 d后的高敏C-反应蛋白(hs CRP)、降钙素原(PCT)、血肌酐(SCr)、血尿素氮(BUN)和中性粒细胞百分比(N%)均显著低于治疗前(P<0.05);实验组治疗3 d后的hs CRP、PCT、SCr、BUN和N%均显著低于对照组(P<0.05)。两组患者7 d病死率无显著差异(P>0.05);实验组28 d病死率显著低于对照组(P<0.05)。结论对于脓毒血症AKI患者早期行CRRT治疗,可有效消除炎症介质,改善肾功能,提高患者存活率。Objective To analyze the clinical efficacy of sepsis with acute kidney injury （AKI） patients underwent continuous renal replacement therapy （ continuous renal replacement therapy, CRRT）. Methods 92 cases with septic AKI hospitalized in our department from January 2012 to July 2014 were randomly divided into experimental and control groups. The experimental group received CRRT treatment; control group received conventional drug therapy. The vital signs, serum markers, 7 d and 28 d mortality in two groups of patients before and after treatment were compared. Results The SBP, DBP, MAP, urine volume and SpO2 3 d after treatment in two groups of patients were significantly higher than before treatment （ P 〈 0.05 ）. The SBP, DBP, MAP, urine volume and SpO2 3d after treatment in the experimental group were significantly higher the control group （ P 〈 0.05 ）. The hsCRP, PCT, SCr, BUN and N% 3 d after treatment in two groups of patients were significantly lower than before treatment （ P 〈 0.05 ）. The hsCRP, PCT, SCr, BUN and N% 3d experimental group after treatment were significantly lower than the control group （ P 〈 0. 05 ）. Two groups of patients did not have significant differences in mortality 7 d （ P 〉 0. 05 ）. 28 d mortality in the experimental group was significantly lower than the control group （ P 〈 0.05 ）. Conclusion CRRT treatment for early stage patients with septic AKI can effectively eliminate inflammation; improve kidney function and patient survival.

关 键 词：脓毒血症 急性肾损伤 连续性肾脏替代治疗 

分 类 号：R459.7[医药卫生—急诊医学]