[1]白 准,刘旭丽,曾维忠,等.持续肾脏替代治疗时机对感染性休克合并急性肾损伤患者预后的影响[J].医学信息,2020,33(08):116-117.[doi:10.3969/j.issn.1006-1959.2020.08.036]
　BAI Zhun,LIU Xu-li,ZENG Wei-zhong,et al.Effect of Continuous Renal Replacement Therapy on the Prognosis of Patients with Septic Shock and Acute Kidney Injury[J].Medical Information,2020,33(08):116-117.[doi:10.3969/j.issn.1006-1959.2020.08.036]
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持续肾脏替代治疗时机对感染性休克合并急性肾损伤患者预后的影响()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
33卷
期数:
2020年08期
页码:
116-117
栏目:
临床研究
出版日期:
2020-04-15

文章信息/Info

Title:
Effect of Continuous Renal Replacement Therapy on the Prognosis of Patients with Septic Shock and Acute Kidney Injury
文章编号:
1006-1959（2020）08-0116-02
作者:
白 准; 刘旭丽; 曾维忠; 等
（湖南省株洲市中心医院重症医学科，湖南 株洲 412000）
Author(s):
BAI Zhun; LIU Xu-li; ZENG Wei-zhong; et al
(Department of Intensive Medicine,Zhuzhou Central Hospital,Zhuzhou 412000,Hunan,China)
关键词:
持续肾脏替代; 治疗时机; 感染性休克; 急性肾损伤
Keywords:
Continuous renal replacement; Timing of treatment; Septic shock; Acute kidney injury
分类号:
R459.7；R692.5
DOI:
10.3969/j.issn.1006-1959.2020.08.036
文献标志码:
A
摘要:
目的 研究持续肾脏替代治疗时机对感染性休克合并急性肾损伤患者预后的影响。方法 选取2018年5月~2019年5月在我院在诊治的90例感染性休克合并急性肾损伤患者为研究对象，采用随机数字表法分为对照组和观察组，各45例。对照组在诊断后12 h内给予持续肾脏替代治疗，观察组在诊断后48 h后给予持续肾脏替代治疗，比较两组治疗后肾功能指标（血肌酐、血尿氮素）、心率、平均动脉压、机械通气时间、持续肾脏替代治疗时间、病死率。结果 治疗后观察组血肌酐、血尿氮素水平均低于对照组（P＜0.05）；观察组心率小于对照组，平均动脉压大于对照组（P＜0.05）；观察组机械通气时间短于对照组（P＜0.05）；两组持续肾脏替代治疗时间比较，差异无统计学意义（P＞0.05）；两组30、60、90 d病死率比较，差异无统计学意义（P＞0.05）。结论 持续肾脏替代治疗感染性休克合并急性肾损伤患者可改善血流动力学和肾功能，缩短机械通气时间，可使内环境趋于稳定，但不同时机开始持续肾脏替代治疗不能改善患者存活率，对患者预后无明显影响。
Abstract:
Objective To study the effect of continuous renal replacement therapy on the prognosis of patients with septic shock and acute kidney injury.Methods 90 patients with septic shock and acute kidney injury who were diagnosed and treated in our hospital from May 2018 to May 2019 were selected as the research objects, using the random number table method to divided into control group and observation group, with 45 cases in each group. The control group was given continuous renal replacement therapy within 12 h after diagnosis, and the observation group was given continuous renal replacement therapy after 48 h after diagnosis. The renal function indexes (blood creatinine, blood urea nitrogen), heart rate, mean arterial pressure, mechanical ventilation time, duration of continuous renal replacement therapy, and mortality were compared between the two groups after treatment.Results After treatment, the blood creatinine and blood urinary nitrogen levels of the observation group were lower than the control group(P<0.05); the heart rate of the observation group was less than the control group, the average arterial pressure was greater than the control group(P<0.05); the mechanical ventilation time of the observation group was shorter than that of the control group (P<0.05); the duration of continuous renal replacement therapy between the two groups was not statistically significant (P＞0.05);there was no statistically significant difference in mortality between the two groups at 30, 60, and 90 d (P＞0.05).Conclusion Continuous renal replacement therapy for patients with septic shock and acute kidney injury can improve hemodynamics and renal function, shorten the time of mechanical ventilation, and stabilize the internal environment. However, starting continuous renal replacement therapy at different times cannot improve the survival rate of patients, and no significant effect on the patient’s prognosis.

参考文献/References:

[1]郑俊波,戴青青,温良鹤,等.感染性休克患者持续性肾脏替代治疗时β-内酰胺类抗生素用药剂量分析[J].中国血液净化,2017,16(7):451-454.[2]Kashani K,Mehta RL.We restrict CRRT to only the most hemodynamically unstable patients[J].Semin Dial,2016(29):268-271.[3]伍增龙,黄永鹏,马俊,等.感染性休克患者CRRT持续肾脏替代治疗中以PICCO指导液体管理对患者临床预后的作用[J].山西医药杂志,2017,46(20):2484-2487.[4]杨晓燕,梅劲超.连续性肾脏替代疗法在感染性休克致急性肾功能衰竭中的应用[J].华南国防医学杂志,2014,28(6):601-602.[5]Colon Hidalgo D,Patel J,Masic D,et al.Delayed vasopressor initiation is associated with increased mortality in patients with septic shock[J].Journal of critical care,2019,11(55):145-148.

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更新日期/Last Update: 2020-04-15