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目的评价在急性肾损伤中使用连续性高剂量肾脏替代治疗是否可以降低患者的病死率。方法检索了PubMed/MEDLINE、EMBASE和Cochrane Library电子数据库的急性肾损伤中使用连续性高剂量肾脏替代治疗的随机对照试验(randomized controlled trials,RCT),使用优势比进行计算。结果共分析6组研究,2522例患者纳入本次研究,与常规剂量组相比,连续性高容量肾脏替代治疗不能降低患者的存活率(OR=1.10,95%CI:0.93～1.30,P=0.002,I2=73.0%),不能缩短平均住院日,但可以明显改善肾脏恢复。结论连续性高容量肾脏替代治疗仅仅能够改善肾脏恢复,在改善存活率与缩短平均住院日上并不能取得更多的益处。
Objective To evaluate whether the use of continuous high-dose renal replacement therapy in acute kidney injury can reduce the patient’s mortality. Methods Randomized controlled trials (RCTs) of consecutive high-dose renal replacement therapy in acute kidney injury in the PubMed / MEDLINE, EMBASE and Cochrane Library electronic databases were searched and calculated using odds ratios. Results A total of 622 studies were included in this study. Of 2522 patients enrolled in this study, continuous high-capacity renal replacement therapy did not reduce the survival rate of patients (OR = 1.10, 95% CI: 0.93 to 1.30, P = 0.002, I2 = 73.0%), can not shorten the average length of stay, but can significantly improve kidney recovery. Conclusion Continuous high-capacity renal replacement therapy can only improve kidney recovery, and can not achieve more benefits in improving survival rate and shortening the average length of stay.