ICU感染性休克合并急性肾损伤患者应用高流量血液滤过治疗的价值研讨

摘要

Objective Analysis of the value of high flow hemofiltration ( HVHF ) in the treatment of patients with septic shock and acute kidney injury.Methods 20 cases of ICU patients with septic shock and acute kidney injury were divided into observation group ( application HVHF therapy) and control group ( renal replace treatment, namely CRRT ) according to different treatment method. Recorded amount of rehydration, norepinephrine usage, IL-10 and IL-6 level, and assessed renal tubular damage. Results The infusion volume in treatment group at 12 h, 24 h and 36 h were fewer than the control group. Epinephrine use in observation group at 24h and 36 h was relatively less than the control. The IL-10 levels in treatment group at 12 h, 24 h and 36 h were lower than those of control group, IL-6 levels at 24 h and 36h were lower than the control group. Renal tubular injury score in observation group was lower than those of control group. All the differences were statistically significant,P<0.05. Conclusions In the treatment of septic shock and acute kidney injury, the application of HVFE can reduce amount of fluid resuscitation and vascular active drugs, inhibit inflammation, relieve kidney damage, is worthy of application.%目的：分析感染性休克合并急性肾损伤应用高流量血液滤过( HVHF)治疗的价值。方法将20例患者ICU感染性休克并急性肾损伤患者按治疗方法不同分为观察组(应用HVHF治疗)和对照组(行肾脏代替治疗，即CRRT)。记录补液量、去甲肾上腺素使用量、IL-10、IL-6水平，评估肾小管损伤。结果观察组治疗12 h、24 h及36 h输液量均较对照组少，第24 h、36 h去肾上腺素使用量较对照组少；观察组治疗12 h、24 h、36 h时IL-10水平较对照组低，第24 h、36 h时IL-6水平低于对照组；观察组肾小管损伤评分较对照组低。 P均<0.05。结论感染性休克并急性肾损伤应用HVHF可减少液体复苏量及血管活性药物量，抑制炎症，缓解肾损伤，值得应用。