【摘要】 目的研究与分析高流量血液滤过治疗ICU感染性休克合并急性肾损伤的临床效果。方法该院采取随机的原则选取来该学院下属医院进行治疗的患有ICU感染性休克合并急性肾损伤的96例患者(2016年4月—2018年4月),随后采取随机数字法将患者分为两组,将其命名为高流量血液滤过组与肾脏代替治疗组,每组各48例。其中高流量血液滤过组患者采取高流量血液滤过治疗,而肾脏代替治疗组患者采取肾脏代替治疗,随后观察两组患者的输液量、去肾上腺素使用量、IL-10、IL-6水平以及肾小管损伤评分等情况。结果高流量血液滤过组患者的第12、24 h及36 h输液量、去甲肾上腺素使用量等情况[(36.22±14.23)g/(kg·min),(51.12±16.75)g/(kg·min),(45.28±9.18)g/(kg·min),(1.19±0.22)dL,(1.04±0.22)dL,(0.34±0.26)dL],显著优于肾脏代替治疗组[(95.08±12.26)g/(kg·min),(102.34±13.86)g/(kg·min),(108.33±16.15)g/(kg·min),(1.39±0.28)dL,(1.31±0.12)dL,(1.29±0.46)dL],差异有统计学意义。且高流量血液滤过组患者的IL-10、IL-6水平以及肾小管损伤评分等情况(48.92±8.12)pg/dl、(31.06±4.18)pg/dl、(36.09±2.10)pg/dl、(133.08±19.66)pg/dl、(113.22±16.17)pg/dl、(100.44±15.28)pg/dl、(115.42±18.22)分,显著优于肾脏代替治疗组(62.08±10.23)pg/dl、(46.16±4.21)pg/dl、(45.88±3.23)pg/dl、(168.22±17.32)pg/dl、(141.65±18.96)pg/dl、(130.95±16.22)pg/dl,(142.39±16.52)分,差异有统计学意义(P<0.05)。结论高流量血液滤过治疗ICU感染性休克合并急性肾损伤的临床效果显著,值得进一步推广。更多还原

【Abstract】 Objective To study and analyze the clinical effect of high-flow hemofiltration in the treatment of ICU septic shock with acute kidney injury. Methods Ninety-six patients with ICU septic shock and acute kidney injury who were treated in the college affiliated hospital on a random basis(April 2016 to April 2018) were randomized to two groups,they were named as high-flow hemofiltration group and kidney replacement treatment group, 48 cases in each group. Among them, patients with high-flow hemofiltration group underwent high-flow hemofiltration, while patients in the kidney replacement group received renal replacement therapy. Then, the infusion volume, norepinephrine use, IL-10, IL-6 levels were observed in the two groups. And renal tubular injury scores and so on. Results The infusion volume and norepinephrine usage at 12 h, 24 h and 36 h in the high-flow hemofiltration group [(36.22±14.23)g/(kg·min),(51.12±16.75)g/(kg·min),(45.28±9.18)g/(kg·min)],(1.19±0.22)dL,(1.04±0.22)dL,(0.34±0.26)dL, significantly better than the renal replacement treatment group(95.08 ±12.26)g/(kg·min),(102.34 ±13.86)g/(kg·min),(108.33 ±16.15)g/(kg·min),(1.39±0.28)dL,(1.31±0.12)dL, 1.29±0.46)dL, the difference was statistically significant. In addition, the levels of il-10 and il-6 as well as the renal tubular injury score of the patients with high flow blood filtration were significantly better than those of the renal replacement treatment group(48.92 ±8.12)pg/dl,(31.06 ±4.18)pg/dl,(36.09 ±2.10)pg/dl,(133.08±19.66)pg/dl,(113.22±16.17)pg/dl,(100.44±15.28)pg/dl,(115.42±18.22)points and significantly better than those of the renal replacement treatment group(62.08 ±10.23)pg/dl,(46.16 ±4.21)pg/dl,(45.88 ±3.23)pg/dl,(168.22 ±17.32)pg/dl,(141.65±18.96)pg/dl,(130.95±16.22)pg/dl,(142.39±16.52)points,The difference was statistically significant(P<0.05).Conclusion The clinical effect of high-flow hemofiltration in the treatment of ICU septic shock with acute kidney injury is significant and worthy of further promotion.更多还原