血液灌流联合连续性血液滤过治疗脓毒血症合并急性肾损伤的效果  

Effect of Hemoperfusion Combined with Continuous Hemofiltration in the Treatment of Sepsis Complicated with Acute Kidney Injury

作　　者：黄鹏[1] 黄寨[1] 秦文波[1] 陆政[1] 莫祖聪[1] 张云利 Huang Peng;Huang Zhai;Qin Wen-bo;Lu Zheng;Mo Zu-cong;Zhang Yun-li(Department of Critical Care Medicine II,Guangxi Zhuang Autonomous Region People's Hospital,Nanning 530021,Guangxi,China)

机构地区：[1]广西壮族自治区人民医院重症医学科二病区,广西南宁530021

出　　处：《中外医药研究》2022年第18期30-32,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

基　　金：广西医疗卫生适宜技术开发与推广应用项目(编号:S2019082)。

摘　　要：目的:探讨血液灌流联合连续性血液滤过治疗脓毒血症合并急性肾损伤的效果。方法:选取2020年1月—2022年6月广西壮族自治区人民医院重症医学科收治的脓毒症合并急性肾功能损伤患者60例为研究对象,采用随机数字表法分为对照组与观察组,各30例。对照组在常规抗脓毒症治疗的基础上给予连续性高容量血液滤过(CHVHF)治疗,观察组在对照组基础上给予血液灌流。比较两组患者慢性健康评分(APACHEⅡ)、序贯性脏器衰竭评分(SOFA)、血压值[收缩压(SBP)、舒张压(DBP)]、碱性磷酸酶(ALP)值、酸碱度、28 d全因死亡率、肾动脉阻力指数(RRI)及彩色多普勒血流评估(RCDFI)。结果:干预后2、3、7 d,观察组SOFA分数低于对照组,APACHEⅡ分数高于对照组,差异有统计学意义(P<0.05);干预后,观察组降钙素原、C反应蛋白、肿瘤坏死因子-α、白细胞介素-6水平低于对照组,差异有统计学意义(P<0.05);干预后,SBP、DBP高于对照组,观察组ALP水平低于对照组,酸碱度高于对照组,差异有统计学意义(P<0.05);观察组28 d全因死亡率低于对照组,差异有统计学意义(P<0.05);干预后,两组患者RRI值均降低,观察组低于对照组,差异有统计学意义(P<0.05);观察组CDFI指标0级、1级比例低于对照组,2级、3级比例高于对照组,差异有统计学意义(P<0.05)。结论:血液灌流联合连续性血液滤过治疗脓毒血症合并急性肾损伤效果显著,能改善患者APACHEⅡ评分及SOFA分数、血压值、酸碱度及ALP值、减少RRI值,改变CDFI指标。Objective:To investigate the effect of hemoperfusion combined with continuous hemofiltration in the treatment of sepsis complicated with acute kidney injury.Methods:Sixty patients with sepsis complicated with acute kidney injury admitted to the Department of Intensive Care Medicine of Guangxi Zhuang Autonomous Region People's Hospital from January 2020 to June 2022 were selected as the research objects,and were divided into control group and observation group by random number table method,with thirty cases in each group.The control group was given continuous high volume hemofiltration(CHVHF)on the basis of routine anti-sepsis treatment,and the observation group was given hemoperfusion on the basis of control group.Chronic health score(APACHEⅡ),sequential organ failure score(SOFA),blood pressure(systolic blood pressure(SBP),diastolic blood pressure(DBP),alkaline phosphatase(ALP),pH,28-day all-cause mortality,renal artery resistance index(RRI)and color Doppler flow assessment(RCDFI)were compared between the two groups.Results:At 2,3 and 7 days after intervention,SOFA score in observation group was lower than control group,APACHEⅡscore was higher than control group,the difference was statistically significant(P<0.05).After intervention,the levels of procalcitonin,C-reactive protein,tumor necrosis factor-αand interleukin-6 in observation group were lower than those in control group,and the difference was statistically significant(P<0.05).After intervention,SBP and DBP were higher than control group,ALP level in observation group was lower than control group,pH was higher than control group,the difference was statistically significant(P<0.05).The 28-day all-cause mortality of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).After intervention,RRI values in both groups were decreased,and the observation group was lower than the control group,the difference was statistically significant(P<0.05).The proportion of grade 0 and grade 1 CDFI index in

关 键 词：血液灌流 连续性血液滤过 脓毒血症 急性肾损伤 

分 类 号：R47[医药卫生—护理学]