蒋忠洋, 孙欢. 血液灌流联合血液滤过透析治疗感染性休克合并急性肾损伤的临床观察[J]. 临床肾脏病杂志, 2019, 19(12): 887-890. DOI: 10.3969/j.issn.1671-2390.2019.12.005
    引用本文: 蒋忠洋, 孙欢. 血液灌流联合血液滤过透析治疗感染性休克合并急性肾损伤的临床观察[J]. 临床肾脏病杂志, 2019, 19(12): 887-890. DOI: 10.3969/j.issn.1671-2390.2019.12.005
    JIANG Zhong-yang, SUN Huan. Clinical observation of hemoperfusion combined with hemofiltration dialysis in the treatment of septic shock with acute kidney injury[J]. Journal of Clinical Nephrology, 2019, 19(12): 887-890. DOI: 10.3969/j.issn.1671-2390.2019.12.005
    Citation: JIANG Zhong-yang, SUN Huan. Clinical observation of hemoperfusion combined with hemofiltration dialysis in the treatment of septic shock with acute kidney injury[J]. Journal of Clinical Nephrology, 2019, 19(12): 887-890. DOI: 10.3969/j.issn.1671-2390.2019.12.005

    血液灌流联合血液滤过透析治疗感染性休克合并急性肾损伤的临床观察

    Clinical observation of hemoperfusion combined with hemofiltration dialysis in the treatment of septic shock with acute kidney injury

    • 摘要: 目的 探讨血液灌流(hemoperfusion,HP)联合血液滤过(continuous vena-venous hemofiltration,CVVH)透析治疗感染性休克合并急性肾损伤(AKI)的临床效果。方法 回顾性分析2016年1月至2018年12月间收治的感染性休克合并AKI112例患者的临床资料,根据治疗方法分为观察组(n=52)和对照组(n=60)。治疗前、治疗2周后评估两组患者疗效急性生理与慢性健康评分表(APACHEII)、生命体征心率(HR)、平均动脉压(MAP)、肾功能血肌酐(Scr)、尿素氮(BUN)、尿量、炎症因子指标超敏C反应蛋白(hs-CRP)、白介素-10(IL-10)、肿瘤坏死因子α(TNF-α)。结果 (1)治疗2周后,两组APACHEII得分、HR、炎症因子(hs-CRP、IL-10、TNF-α)均低于治疗前(P<0.05),两组MAP均高于治疗前(P<0.05),观察组变动幅度大于对照组(P<0.05);(2)治疗2周后,两组Scr、BUN、尿量均高于治疗前(P<0.05),观察组Scr、BUN小于对照组(P<0.05),观察组尿量大于对照组(P<0.05)。结论 HP、CVVH两种血液净化方式联合治疗感染性休克合并AKI效果更佳,有利于保护患者肾功能。

       

      Abstract: Objective To explore the clinical effects of hemoperfusion (HP) combined with continuous vena-venous hemofiltration (CVVH) in the treatment of septic shock with acute kidney injury (AKI). Methods The clinical data of 112 patients with septic shock with AKI admitted between January 2016 and December 2018 were retrospectively analyzed. According to the treatment methods, they were divided into observation group (n=52) and control group (n=60). The efficacy indexes of the patients in the two groupsacute physiology and chronic health evaluation (APACHEII), vital signsheart rate (HR), mean arterial pressure (MAP), renal functionserum creatinine (Scr), urea nitrogen (BUN), urine volumeand inflammatory factors indexeshigh-sensitivity C-reactive protein (hs-CRP), interleukin-10 (IL-10), tumor necrosis factor α (TNF-α)were evaluated in the two groups before treatment and after 2 weeks of treatment. Results (1) After 2 weeks of treatment, the APACHE II score, HR and inflammatory factors (hs-CRP, IL-10 and TNF-α) in the two groups were lower than those before treatment (P<0.05) while the MAP values in the two groups was higher than that before treatment (P<0.05), and the changes in the observation group were greater than those in the control group (P<0.05). (2) After 2 weeks of treatment, the Scr, BUN and urine volume in the two groups were higher than those before treatment (P<0.05), and the increases of Scr and BUN in the observation group were smaller than those in the control group (P<0.05), while the increase of urine volume in the observation group was greater than that in the control group (P<0.05). Conclusions Combination between the two blood purification methods of HP and CVVH has better effects in the treatment of septic shock with AKI, and it is beneficial to protect renal function of the patients.

       

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