连续性肾脏替代治疗对ICU脓毒血症患者疗效的影响  

Effect of continuous renal replacement therapy on efficacy of patients with sepsis in ICU

作　　者：张琪[1] 姜利[1] 席修明[1] 费雅楠[2] 

机构地区：[1]首都医科大学附属复兴医院重症医学科,北京市100038 [2]北京市海淀医院风湿免疫科,北京市100080

出　　处：《广西医学》2016年第9期1215-1218,共4页Guangxi Medical Journal

基　　金：国家科技支撑计划(2012BAI11B05)

摘　　要：目的探讨连续性肾脏替代(CRRT)治疗对ICU脓毒血症患者临床疗效的影响。方法 ICU收治的脓毒血症患者110例,按随机数字表法分为观察组与对照组,每组55例,两组均给予容量复苏、纠正酸中毒、抗感染、使用血管活性药物、机械通气、代谢支持等综合治疗,对照组给予血液灌流治疗,观察组在血液灌流的基础上给予CRRT治疗。比较两组的疗效、治疗前后的肾功能及凝血功能。结果治疗后观察组有效率为92.7%,明显高于对照组的70.9%(P<0.05)。治疗后,两组急性生理与慢性健康Ⅱ评分、血清肌酐、尿素氮水平均低于治疗前(P<0.05),并且观察组以上指标均低于对照组(P<0.05);治疗后两组血清凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)值均高于治疗前(P<0.05),但治疗后观察组PT、APTT值低于对照组(P<0.05)。结论 CRRT疗法治疗能促进ICU内脓毒血症患者肾功能恢复,防止凝血功能紊乱,有利于改善病情,提高治疗效果。Objective To explore the effect of continuous renal replacement therapy（CRRT） on the efficacy of patients with sepsis in ICU. Methods A total of 110 patients in ICU were divided into observation group and control group using the random number table,with 55 cases in each group. Both groups were given comprehensive treatment including volume resuscitation, correction of acidosis, anti-infection, use of vasoactive agents, mechanical ventilation and metabolic support therapy. The control group received hemoperfusion, and the treatment group received CRRT on the basis of hemoperfusion. The efficacy, renal function and coagulation function before and after treatment were compared between the two groups. Results After treatment,the effective rate of the observation group was 92.7% and was significantly higher than that of the control group（70.9% ,P 〈0.05）. The scores of Acute Physiology and Chronic Health Evaluation Ⅱ,the levels of serum creatinine and urea nitrogen after treatment were lower than those before treatment in both groups （P 〈 0. 05 ） ,and these indices in the observation group were lower than those in the control group after treatment（P 〈 0.05）. The serum prothrombin time（FI＇） and activated partial prothrombin time （APTF） after treatment were longer than those before treatment in both groups （ P 〈 0.05 ）, but PT and AFTF in the observation group were shorter than those in the control group after treatment （ P 〈 0.05 ）. Conclusion CRRT can promote the recovery of renal function, prevent coagulation dysfunction,is benefit to improve the disease and improve the therapeutic efficacy of patients with sepsis in ICU.

关 键 词：脓毒血症 连续性肾脏替代治疗 肾功能 凝血功能 疗效 

分 类 号：R459.2[医药卫生—治疗学]