摘要
目的 探讨不同CRRT治疗方案对脓毒症并发肾损伤患者的治疗效果对比.方法 选取2015年1月至2016年1月在本院诊治的脓毒症并发肾损伤患者90例,通过随机数表法分为高剂量组、中剂量组和低剂量组,各30例.三组患者均以CRRT治疗,但高剂量组置换量定为100 mL·（kg·h）^-1,中剂量组置换量定为65 mL.（kg·h）^-1,低剂量组置换量定为35mL·（kg·h）^-1,对三组方案治疗前后患者的外周血指标、生化指标以及APACHEⅡ评分比较.结果 治疗后的所有患者外周血各指数均高于治疗前,高剂量组的尿素氮（urea nitrogen,BUN）低于中剂量和低剂量组[（44.11±15.02） mmol/L、（47.12±16.81） mmol/L和（48.89 ±17.25）mmol/L,P〈0.05],高剂量组的超敏C-反应蛋白（C-reactive protein,CRP）指数低于中剂量组和低剂量组[（78.60±19.62） mg/L、（89.43 ±20.71） mg/L和（98.11±20.93） mg/L,P〈0.05];治疗后,患者的APACHEⅡ评分均优于治疗前,其中高剂量组分数小于中剂量组和低剂量组[（13.39±3.68）分、（15.37 ±3.90）分和（17.42 ±3.74）分,P〈0.05];在肌酐、降钙素原（procalcitonin,PCT）、CD4＋/CD8＋的比对中,高剂量组患者的改善效果更加优异（P〈0.05）.结论 CRRT治疗对脓毒症并发肾损伤患者的治疗过程中,可恢复患者的免疫系统,改善患者的身体状况,具有明显的疗效,其中以大剂量方案的效果最为明显,值得推广.
Objective To compare efficacy of different continuous renal replacement therapy （CRRT） regimens in patients with sepsis complicated with renal injury.Methods A total of 90 patients with sepsis complicated with renal injury from January 2015 to January 2016 in our hospital were selected as research objects,the patients were randomly divided into high-dose group,middle-dose group and low-dose group,each group 30 cases,three groups were treated with CRRT,the replacement dose of the high dose group was 100 mL · （kg · h）^-1,the middle dose group was 65 mL · （kg ·h）^-1,and the low dose group was 35 mL · （kg · h）^-1,the peripheral blood parameters,biochemical parameters and APACHE Ⅱ score of the patients before and after treatment were compared.Results All patients after treatment by peripheral blood index were higher than before treatment,blood urea nitrogen （BUN） of high-dose group was lower than the middle dose and low dose group[（44.11 ±15.02） mmol/L vs.（47.12 ± 16.81） mmol/L,（48.89 ± 17.25） mmol/L,P 〈 0.05],and high-sensitivity C-reactive protein （CRP） index in the high-dose group was also lower than in the medium-dose group and in the low-dose group [（78.60 ± 19.62） mg/L vs.（89.43 ± 20.71） mg/L,（98.11 ±20.93）mg/L,P 〈 0.05].After treatment,APACHE Ⅱ score was better than before treatment,in which the high dose group was lower than the middle dose group and low dose group[（13.39 ± 3.68）score vs.（15.37 ± 3.90） score,（17.42 ± 3.74） score,P 〈 0.05].At the same time,the improvement of creatinine,PCT and CD4 ＋/CD8 ＋ was more excellent （P 〈 0.05）.Conclusions CRRT treatment of patients with sepsis complicated with renal injury can restore the immune system and improve the patient＇s physical condition,a significant effect,of which the effect of high-dose program is the most obvious and worthy of promotion.
作者
冯晓娟
朱旭生
罗秋凤
Feng Xiaojuan;Zhu Xusheng;Luo Qiufeng.(Department of Severe Medicine, the First Affiliated Hospital of Guangxi University of Science and Technology, Guangxi 545002, Chin)
出处
《国际泌尿系统杂志》
2018年第3期464-467,共4页
International Journal of Urology and Nephrology
关键词
脓毒症
肾疾病
肾替代疗法
Sepsis
Kidney Diseases
Renal Replacement Therapy
