不同血液净化方法对脓毒症急性肾损伤患者血流动力学及预后的影响

发布时间：2018-04-02 11:24

  本文选题：血液净化方法　切入点：脓毒症急性肾损伤　出处：《中国老年学杂志》2017年24期

【摘要】：目的探讨不同血液净化方法对脓毒症急性肾损伤(SAKI)患者血流动力学及预后的影响。方法选择SAKI患者136例,根据血液净化方式的不同分为观察组和对照组各68例,两组均给予常规针对性治疗,并给予血液净化治疗,观察组选择连续性肾脏替代疗法(CRRT),对照组选择间歇性血液透析(IHD),监测并对比两组预后指标、血流动力学指标[心率(HR),平均动脉压(MAP),血氧饱和度(Sa O2)]、实验室指标(血肌酐和白蛋白),并对比两组不同时期急性生理学及慢性健康状况评分(APACHE)Ⅱ变化值及少尿天数。结果观察组肾功能恢复率较对照组明显升高(P0.05)。治疗后两组HR明显降低,且观察组明显低于对照组,MAP和Sa O2水平均明显升高(均P0.05)。治疗后两组APACHEⅡ评分和血肌酐水平明显降低,且观察组明显低于对照组,白蛋白水平明显高于对照组(均P0.05)。观察组Ⅰ期患者APACHEⅡ评分变化值明显大于对照组,而少尿天数明显少于对照组(均P0.05)。结论应用CRRT与IHD方式均可有效治疗SAKI患者,能够改善患者血流动力学及预后,但CRRT的肾功能恢复率更高,对Ⅰ期SAKI患者的预后更好。
[Abstract]:Objective to investigate the effect of different blood purification methods on hemodynamics and prognosis of patients with septic acute renal injury.Methods one hundred and thirty-six patients with SAKI were divided into observation group (n = 68) and control group (n = 68).Continuous renal replacement therapy (CRRTT) was used in the observation group and intermittent hemodialysis (IHD) was used in the control group to monitor and compare the prognostic indexes of the two groups.Results the recovery rate of renal function in the observation group was significantly higher than that in the control group (P 0.05).After treatment, the HR of the two groups decreased significantly, and the levels of map and SaO2 in the observation group were significantly lower than those in the control group (P 0.05).After treatment, the APACHE 鈪，

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