摘要
目的评估连续肾脏替代治疗(Continuous renal replacement therapy,CRRT)对蜂蜇伤后急性肾损伤(Acute kidney injury,AKI)患者的肾脏预后的影响。方法回顾性分析2020年12月-2023年12月本院收治的100例蜂蜇伤引发AKI患者的临床资料,根据接受的治疗方法分为观察组和对照组两组,每组各50例。所有患者都接受了血液灌流(Hemoperfusion,HP)治疗,并辅以糖皮质激素、输血和补液等支持性治疗。此外,观察组患者还接受了连续性肾脏替代治疗。研究对比了两组在30 d内的病死率、肾功能恢复、生命体征稳定性及肾脏长期预后等方面的差异。结果30 d内观察组的病死率为5.00%,低于对照组的病死率(P<0.05)。治疗后,两组患者的尿酸、血肌酐和尿素氮水平均有显著下降,同时24 h尿量显著增加,观察组在这些指标上的改善幅度均优于对照组。此外,与治疗前相比,两组患者在治疗后的血氧饱和度与平均动脉压均明显提高,中心静脉压与心率均显著降低,且观察组的改善幅度大于对照组(P<0.05)。在纳入肾脏预后比较的90例患者中,对照组在30 d、60 d和90 d的完全恢复率分别为7.14%、23.81%和73.91%。另有9例(21.43%)发展为慢性肾病(Chronic Kidney Disease,CKD),其中2例(4.76%)进展为终末期肾病(End-Stage Renal Disease,ESRD)。相比之下,观察组在30 d、60 d和90 d的完全恢复率分别为16.67%、47.92%和91.67%,且有4例(8.33%)发展为CKD。观察组在60 d和90 d的肾脏恢复人数显著高于对照组(P<0.05),90 d-CKD与90 d-ESRD人数少于对照组,但差异无统计学意义(P>0.05)。结论CRRT在蜂蜇伤后AKI患者中,相比仅接受HP和对症支持治疗的对照组,能显著改善肾功能恢复速度和生命体征,降低病死率,有助于改善短期肾脏预后。
Objective To evaluate the impact of continuous renal replacement therapy(CRRT)on the renal prognosis of patients with acute kidney injury(AKI)following bee stings.Methods This study conducted a retrospective analysis on the clinical data of 100 patients treated at our hospital due to AKI caused by bee stings from December 2020 to December 2023.These patients were divided into the observation group and the control group,each consisting of 50 patients,based on the treatment method they received.All patients underwent hemoperfusion(HP)treatment,supplemented with corticosteroids,blood transfusions,and fluid replenishment as supportive care.Additionally,patients in the observation group received continuous renal replacement therapy(CRRT).The study compared differences between the two groups in terms of 30-days mortality,renal function recovery,stability of vital signs,and long-term renal prognosis.Results Within 30 days,the mortality rate in the observation group was 5.00%,which was higher than that in the control group(P<0.05).After treatment,both groups showed significant reductions in levels of uric acid,serum creatinine,and urea nitrogen,and a significant increase in 24-hour urine output,and the observation group showing greater improvement in these indicators.Additionally,compared with those before treatment in the two groups,the oxygen saturation and mean arterial pressure were significantly increased,and the central venous pressure and heart rate were significantly decreased in the two groups,and the improvement in the observation group was greater than those in the control group(P<0.05).Among the 90 patients included in the renal prognosis comparison,the full recovery rates at 30th day,60th day,and 90th day for the control group were 7.14%,23.81%,and 73.91%,respectively.Additionally,9 cases(21.43%)progressed to Chronic Kidney Disease(CKD),of which 2 cases(4.76%)progressed to End-Stage Renal Disease(ESRD).In contrast,the observation group had full recovery rates of 16.67%,47.92%,and 91.67%at 30th day,60th day,and 90th day,respectively,with 4 cases(8.33%)progressing to CKD.The recovery rates in the observation group at 60th day and 90th day were significantly higher than those in the control group(P<0.05),but the differences in the number of patients with CKD and ESRD at 90th day were not statistically significant(P>0.05).Conclusions In patients with AKI following bee stings,CRRT,compared to the control group that only received HP and symptomatic supportive treatment,significantly improves the rate of renal function recovery and vital signs,reduces mortality,and aids in enhancing short-term renal prognosis.
作者
郭哨恺
王世俊
张增强
Guo Shaokai;Wang Shijun;Zhang Zengqiang(Anyang People’s Hospital,Anyang,Henan 453000,China)
出处
《齐齐哈尔医学院学报》
2025年第8期771-774,共4页
Journal of Qiqihar Medical University
关键词
连续肾脏替代
蜂蜇伤
急性肾损伤
肾脏预后
Continuous renal replacement
Bee sting injury
Acute kidney injury
Renal prognosis
