脓毒症并发急性肾损伤患者经CRRT后28天内死亡的高危因素分析  

Analysis of High-Risk Factors for Death Within 28 Days After CRRT in Patients with Sepsis Complicated with Acute Kidney Injury

作　　者：刘攀 吴鹏 张其强 LIU Pan;WU Peng;ZHANG Qiqiang(Department of Intensive Care Medicine,Linyi Central Hospital,Linyi 276000,China)

机构地区：[1]山东省临沂市中心医院重症医学科,山东临沂276000

出　　处：《中国伤残医学》2025年第7期55-58,共4页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:分析脓毒症并发急性肾损伤(AKI)患者经连续肾脏替代治疗(CRRT)后28d内死亡的高危因素。方法:回顾性分析2022年1月—2023年12月临沂市中心医院收治的91例行CRRT的脓毒症并发AKI患者资料,统计其治疗后28d内的死亡率;另收集患者的年龄、性别等信息,分析影响其28d内死亡的高危因素。结果:91例行CRRT的脓毒症并发AKI患者中,28d内死亡15例,死亡率16.48%。单因素分析显示:年龄、机械通气治疗时间、营养不良、多器官功能障碍综合征(MODS)、高乳酸血症、急性生理功能与慢性健康状况评分系统Ⅱ评分与脓毒症并发AKI患者CRRT后28d内死亡有关,差异均有统计学意义(P<0.05)。Logistic回归分析显示:年龄>60岁、机械通气治疗时间>2周、有营养不良、有MODS、有高乳酸血症、APACHEⅡ评分>20分为脓毒症并发AKI患者经CRRT治疗后28d内死亡的独立危险因素(P<0.05)。结论:机械通气治疗时间>2周、有营养不良、有MODS、有高乳酸血症、APACHEⅡ评分>20分为脓毒症并发AKI患者CRRT后28d内死亡的独立高危因素。Objective:To analyze the risk factors of death within 28 days after continuous renal replacement therapy(CRRT)in patients with sepsis complicated with acute kidney injury(AKI).Methods:Data of 91 sepsis complicated with AKI patients underwent CRRT admitted to Linyi Central Hospital from January 2022 to December 2023 were retrospectively analyzed,and the death rate within 28 days after treatment was counted.The age,gender and other information of the patients were also collected,and the high-risk factors affecting their death within 28 days were analyzed.Results:Among 91 patients with sepsis complicated with AKI who underwent CRRT,15 died within 28 days,with a death rate of 16.48%.Single factor analysis showed that:age,time of mechanical ventilation treatment,malnutrition,multiple organ dysfunction syndrome(MODS),hyperlactacemia,acute physiology and chronic health evaluationⅡscore were associated with death within 28 days after CRRT in patients with sepsis complicated with AKI,and the differences were statistically significant(P<0.05).Logistic regression analysis shows:age>60 years old,duration of mechanical ventilation treatment>2 weeks,malnutrition,had MODS,had hyperlactacemia,APACHEⅡscore>20 points were independent risk factors for death within 28 days after CRRT in patients with sepsis complicated with AKI(P<0.05).Conclusion:Mechanical ventilation treatment time>2 weeks,malnutrition,MODS,hyperlactacemia,APACHEⅡscore>20 points are independent risk factors for death within 28 days after CRRT in patients with sepsis complicated with AKI.

关 键 词：脓毒症并发急性肾损伤 连续肾脏替代治疗 死亡 高危因素 

分 类 号：R692[医药卫生—泌尿科学]