参附注射液治疗感染性休克致急性肾损伤的效果  

Clinical research on the effect of Shenfu injection on acute kidney injury induced by septic shock

作　　者：何琨 周大勇[1] 洪峰[1] 武慧[1] He Kun;Zhou Dayong;Hong Feng;Wu Hui(ICU,the First Affilicated Hospital of Anhui University of Chinese Medicine,Hefei 230031,China)

机构地区：[1]安徽中医药大学第一附属医院综合重症医学科

出　　处：《中国临床保健杂志》2020年第1期74-78,共5页Chinese Journal of Clinical Healthcare

基　　金：安徽省卫生厅中医药科研课题项目(2012zy22)

摘　　要：目的探讨参附注射液对感染性休克致急性肾损伤病情转归和预后的影响。方法选择重症医学科收治的感染性休克患者58例,按照随机数字表法平均分为常规治疗组(对照组)和加用参附治疗组(参附组)。参附组在常规抗休克治疗的基础上加用参附注射液10 mL/h持续静脉泵入,连续应用3 d。观察两组患者治疗前及治疗后6 h、24 h、72 h的平均动脉压(MAP)、混合静脉血氧饱和度(SvO 2)、滤过钠排泄分数(FENa)、肾衰指数(RFI)、血肌酐清除率(Ccr)、每小时尿量(Uo/h)和6 h、24 h、72 h乳酸清除率(LCR),并记录两组患者休克持续时间、ICU住院时间和28 d病死率等。结果参附组患者治疗后6 h、24 h、72 h的SvO 2、FENa、Uo/h、Ccr均显著高于同期对照组,而RFI则显著低于对照组(P<0.05)。参附组治疗24 h后MAP显著高于对照组(P<0.05)。MAP、SvO 2、FENa、Uo/h、RFI和Ccr在参附组随着治疗时间延长,其疗效呈现稳定的线性递增。参附组患者28 d病死率低于对照组(P<0.05),但ICU住院时间、总住院时间差异均无统计学意义(P>0.05)。结论参附注射液持续静脉注射能够显著改善感染性休克患者的血流动力学及肾功能,降低急性肾损伤的发生率,并能促进急性肾损伤尽快恢复。Objective To observe the curative effect of Shenfu injection and its effect on prognosis of the patients with acute renal injury induced by septic shock.Methods 58 patients with septic shock were admitted to the intensive care unit(ICU).The patients were randomly divided into the conventional treatment group(the control group)and the additional Shenfu treatment group(the Shenfu group).The Shenfu group was treated with Shenfu injection on the basis of the conventional anti-shock treatment.The Shenfu injection was pumped intravenously as 10 mL/h continuously for 3 days.The mean arterial pressure(MAP),mixed venous oxygen saturation(SvO 2),filtration sodium excretion fraction(FENa),renal failure index(RFI),serum creatinine clearance(Ccr),urine volume per hour(Uo/h),and lactate clearance at 6 h,24 h,and 72 h were monitored and recorded before and after treatment in the two groups.The duration of shock,mortality in 28 days and the length of stay in the ICU and 28-day mortality were recorded.Results Compared with the control group,the SvO 2,FENa,Uo/h and Ccr of the patients were significantly higher in the Shenfu group at 6 h,24 h and 72 h after treatment(P<0.05).RFI was significantly lower at the same period in the Shenfu group(P<0.05).MAP was significantly higher in the Shenfu group at 24 h after treatment(P<0.05).With the intervention of Shenfu injection.MAP,SvO 2,FENa,Uo/h,RFI and Ccr showed a stable linear increased.The 28-day mortality was lower in the Shenfu group(P<0.05).However,there was no significant difference in ICU length of stay and total length of stay between two groups(P>0.05).Conclusion Shenfu injection can improve hemodynamics and renal function significantly in patients with septic shock.

关 键 词：急性肾损伤 休克 中成药 血流动力学 

分 类 号：R47[医药卫生—护理学]