摘要
目的探究连续性静脉-静脉血液滤过(CVVH)治疗脓毒症合并急性肾衰竭的临床效果。方法选取2018年1月至2020年12月在本院接受治疗的脓毒症合并急性肾衰竭患者60例,采用随机数字表法分为观察组和对照组,各30例。对照组予以常规治疗,调节酸碱平衡、电解质平衡等,并进行抗感染、利尿等治疗,观察组则在对照组的基础上加用血液滤过(CVVH)的治疗方法。记录治疗前和治疗5d后两组患者血清炎症指标[白细胞(WBC)、C反应蛋白(CRP)、降钙素原(PCT)]、肾功能指标[血清尿素(BUN)、血肌酐(Cr)、尿酸(UA)],比较治疗前和治疗7d后两组患者短期预后状况[序贯器官衰竭估计评分(SOFA评分)、急性生理与慢性健康评分Ⅱ(APACHEⅡ评分)]。结果治疗5d后较治疗前,两组患者炎症标志物(WBC、CRP、PCT)水平、肾功能指标(BUN、Cr、UA)均有下降(P均<0.05),且观察组低于对照组(P均<0.05),治疗7d后较治疗前,两组患者短期预后状况(SOFA评分、APACHEⅡ评分)均有下降(P均<0.05),且观察组低于对照组(P均<0.05)。结论CVVH和常规治疗方式对比,CVVH更能够缓解疗脓毒症合并急性肾衰竭患者的炎症反应,且有利于患者短期预后及对部分肾功能的恢复。
Objective To investigate the clinical effect of continuous veno venous hemofiltration(CVVH)in the treatment of sepsis with acute renal failure.Methods 60 patients with sepsis combined with acute renal failure who were treated in our hospital from January 2018 to December 2020 were selected and randomly divided into the observation group and the control group with 30 patients each.The control group received routine treatment to adjust the acid-base balance and electrolyte balance,and received anti infection and diuretic treatment.The observation group was treated with hemofiltration(CVVH)on the basis of the control group.The serum inflammatory indicators[white blood cell(WBC),C-reactive protein(CRP),procalcitonin(PCT)]and renal function indicators[serum urea(BUN),serum creatinine(Cr),uric acid(UA)]of the patients in the two groups before and after treatment for 5 days were recorded.The short-term prognosis of the patients in the two groups before and after treatment for 7 days was compared[sequential organ failure assessment score(SOFA score),acute physiology and chronic health scoreⅡ(APACHEⅡscore)].Results After 5 days of treatment,the levels of inflammatory markers(WBC,CRP,PCT)and renal function indicators(BUN,Cr,UA)in both groups decreased compared with those before treatment(all P<0.05),and the observation group was lower than the control group(all P<0.05).After 7 days of treatment,the short-term prognosis(SOFA score,APACHEⅡscore)in both groups decreased compared with those before treatment(all P<0.05),and the observation group was lower than the control group(all P<0.05).Conclusions Compared with conventional treatment,CVVH is more effective in relieving the inflammatory reaction of sepsis patients with acute renal failure,and is beneficial to the short-term prognosis and recovery of some renal functions.
作者
范岳彬
林佳
邓旭茂
梁伟杏
Fan Yuebin;Lin Jia;Deng Xumao;Liang Weixing(Department of Critical Care Medicine,Gaoyao District People's Hospital,Zhaoqing,China)
作者简介
通信作者:梁伟杏,E-mail:57155144@qq.com
