连续性肾脏替代治疗在糖尿病乳酸酸中毒中的临床应用  

Clinical Application of Continuous Renal Replacement Therapy in Diabetic Lactic Acidosis

作　　者：李钦浩 巩晓娜 LI Qinhao;GONG Xiaona(Department of Critical Care Medicine,Dongying Honggang Hospital,Dongying,Shandong Province,257000 China)

机构地区：[1]东营鸿港医院重症医学科,山东东营257000

出　　处：《糖尿病新世界》2022年第8期28-31,共4页Diabetes New World Magazine

摘　　要：目的 探讨连续性肾脏替代治疗在糖尿病乳酸酸中毒中的临床应用价值。方法 选择2020年1月—2022年1月该院收治的糖尿病乳酸酸中毒患者80例为研究对象。按照随机数表法分为两组,各40例。对照组采取常规保守对症支持处理,观察组联合使用连续性肾脏替代治疗,比较两组治疗前后机体炎症因子水平及血糖、乳酸及二氧化碳结合力变化,统计两组治疗期间钾、钠代谢失衡比例,统计两组24 h生存例数、48 h生存例数和整体康复例数。结果 治疗后观察组超敏C反应蛋白(hs-CRP)和肿瘤坏死因子(TNF-α)水平均低于治疗前及治疗后对照组,差异有统计学意义(P<0.05);治疗后观察组血糖和乳酸水平低于治疗前及治疗后对照组,二氧化碳结合力高于治疗前及治疗后对照组,差异有统计学意义(P<0.05)。整个治疗过程中观察组出现高钾血症、低钾血症、高钠血症、低钠血症的比例显著低于对照组,差异有统计学意义(P<0.05);观察组24 h生存例数、48 h生存例数和整体康复例数均显著高于对照组,差异有统计学意义(P<0.05)。结论 连续肾脏替代治疗能有效降低糖尿病乳酸酸中毒患者机体炎症因子、血糖、血乳酸水平,提高二氧化碳结合力,维持电解质平衡,提高患者救治成功率。Objective To investigate the clinical value of continuous renal replacement therapy in diabetic lactic acidosis.Methods A total of 80 patients with diabetic lactic acidosis admitted to the hospital from January 2020 to January 2022 were selected as the research subjects.According to the random number table method,they were divided into two groups,each with 40 cases.The control group was treated with conventional conservative symptomatic support,and the observation group was treated with continuous renal replacement therapy.The levels of inflammatory factors and changes in blood glucose,lactic acid and carbon dioxide binding capacity were compared between the two groups before and after treatment.The proportion of potassium and sodium metabolism imbalance in the two groups during the treatment period was counted.The 24 h survival cases,48 h survival cases and overall recovery cases were counted between the two groups.Results After treatment,the levels of high-sensitivity creactive protein(hs-CRP) and tumor necrosis factor(TNF-α) in the observation group were lower than those in the control group before and after treatment,and the differences were statistically significant(P<0.05).After treatment,the blood glucose and lactate levels in the observation group were lower than those in the control group before and after treatment,and the differences were statistically significant(P<0.05).The carbon dioxide binding capacity was higher than that of the control group before and after treatment,and the differences were statistically significant(P<0.05).During the whole treatment process,the proportion of hyperkalemia,hypokalemia,hypernatremia and hyponatremia in the observation group was significantly lower than that in the control group,and the differences were statistically significant(P<0.05).The number of 24 h survival cases,48 h survival cases and overall recovery cases in the observation group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).Conclus

关 键 词：连续性肾脏替代 糖尿病 乳酸酸中毒 二氧化碳结合力 点解释失衡 

分 类 号：R473.5[医药卫生—护理学]