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目的分析脓毒血症急性肾损伤(AKI)患者行连续性肾脏替代治疗(CRRT)的临床疗效。方法选取2012年1月至2014年7月因脓毒血症AKI住院治疗的患者共92例,随机分为实验组和对照组。实验组予以CRRT治疗,对照组予以常规药物治疗。对比两组患者治疗前及治疗3 d后的生命体征、血清学指标、7 d及28 d病死率。结果两组患者治疗3 d后的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、尿量和氧饱和度(Sp O2)均显著高于治疗前(P<0.05);实验组治疗3 d后的SBP、DBP、MAP、尿量和Sp O2均显著高于对照组(P<0.05)。两组患者治疗3 d后的高敏C-反应蛋白(hs CRP)、降钙素原(PCT)、血肌酐(SCr)、血尿素氮(BUN)和中性粒细胞百分比(N%)均显著低于治疗前(P<0.05);实验组治疗3 d后的hs CRP、PCT、SCr、BUN和N%均显著低于对照组(P<0.05)。两组患者7 d病死率无显著差异(P>0.05);实验组28 d病死率显著低于对照组(P<0.05)。结论对于脓毒血症AKI患者早期行CRRT治疗,可有效消除炎症介质,改善肾功能,提高患者存活率。
Objective To analyze the clinical efficacy of continuous renal replacement therapy (CRRT) in patients with sepsis-induced acute kidney injury (AKI). Methods A total of 92 hospitalized patients with AKI from sepsis from January 2012 to July 2014 were randomly divided into experimental group and control group. The experimental group was treated with CRRT, while the control group was treated with conventional drugs. The vital signs and serological markers of the two groups were compared before treatment and after 3 days of treatment, and the mortality rates at 7 d and 28 d were compared between the two groups. Results The systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), urine output and oxygen saturation (Sp O2) of the two groups were significantly higher than those before treatment (P <0.05) After 3 days of treatment, SBP, DBP, MAP, urine output and Sp O2 in the experimental group were significantly higher than those in the control group (P <0.05). The levels of hsCRP, PCT, SCr, BUN and neutrophil percentage (N%) were significantly higher in both groups after 3 days of treatment (P <0.05). The hs CRP, PCT, SCr, BUN and N% of the experimental group after 3 days of treatment were significantly lower than those of the control group (P <0.05). There was no significant difference in the 7-day mortality between the two groups (P> 0.05). The 28-day mortality in the experimental group was significantly lower than that in the control group (P <0.05). Conclusions Early treatment with CRRT in AKI patients with sepsis can effectively eliminate inflammatory mediators, improve renal function and improve patient survival rate.