连续肾脏替代疗法血液净化在重症监护室感染性休克患者中的应用效果研究  

Study the application effect of blood purification of CRRT for patients with septic shock in ICU

作　　者：张娟[1] 黄智勇[1] 谢荣裕 杨淑洁 ZHANG Juan;HUANG Zhi-yong;XIE Rong-yu(Intensive Care Unit,The People＇s Hospital of Rugao,Rugao 226500,China)

机构地区：[1]如皋市人民医院重症医学科,江苏如皋226500

出　　处：《中国医学装备》2018年第11期109-111,共3页China Medical Equipment

摘　　要：目的:研究分析连续肾脏替代疗法(CRRT)血液净化在重症监护室(ICU)感染性休克中的应用效果。方法:选取在医院ICU接受治疗的120例感染性休克患者,将其按照随机数表法分为观察组和对照组,每组60例。对照组患者给予常规治疗,观察组患者在常规治疗的基础上加用CRRT血液净化治疗。对比两组治疗前后临床肌酐、血钾、尿素氮、心率、持续性血液净化(CBP)水平、中心静脉压、平均动脉压和氧合指数变化以及存活率情况。结果:治疗前,两组患者肌酐、血钾、尿素氮、心率、CBP水平以及中心静脉压比较差异无统计学意义。治疗后,对照组患者肌酐、血钾、尿素氮、心率、CBP水平以及中心静脉压均高于观察组,其差异有统计学意义(t=2.101,t=7.623,t=2.660,t=2.746,t=2.408,t=2.333;P<0.05);平均动脉压及氧合指数低于观察组,差异有统计学意义(t=2.857,t=2.218;P<0.05)。对照组患者存活率为75.00%,低于观察组的95.00%,差异有统计学意义(x^2=9.412,P<0.05)。结论:对于ICU感染性休克患者采用CRRT血液净化治疗可有效改善临床症状,减少并发症,提高存活率。Objective To study and analyze the application effect of blood purification of continuous renal replacement therapy （CRRT） for patients with septic shock in ICU. Methods： 120 patients with septic shock who were treated in ICU of hospital were selected for study. The patients were randomly divided into observation group （60 cases） and control group （60 cases）. The patients of control group received routine therapy, while the patients of observation group received CRRT blood purification on the basis of routine therapy. The changes of clinical indexes included creatinine, serum potassium, urea nitrogen, heart rate, the level of continuous blood purification （CBP）, central venous pressure （CVP）, mean arterial pressure, oxygenation index and survival rate pre and post treatment between two groups were compared. Results： There was no significant difference in series of clinical indexes included creatinine, serum potassium, urea nitrogen, heart rate, CBP and CVP pre-treatment between the two groups. After treatment, the levels of creatinine, serum potassium, urea nitrogen, heart rate, CBP and CVP of control group were significantly higher than those of observation group （t=2.101, t=7.623, t=2.660, t=2.746, t=2.408, t=2.333, P〈0.05）. While the mean arterial pressure and oxygenation indexes of the control group were significantly lower than those of the observation group （t=2.857, t=2.218, P〈0.05）. The survival rate of observation group was 95.0%, that was significantly higher than that of control group （75.00%） （χ^2=9.412, P〈0.05）. Conclusion： CRRT blood purification in the treatment for patients with septic shock in ICU can effectively improve patients＇ clinical symptoms, reduce complications, and significantly increase survival rate.

关 键 词：连续肾脏替代疗法 血液净化 ICU感染性休克 应用效果 

分 类 号：R459.5[医药卫生—治疗学]