连续性肾脏替代疗法治疗感染性休克所致的急性肾功能衰竭

摘要

Objective To summarize the clinical effects of continuous renal replacement therapy(CRRT)for the treatment of acute renal failure from septic shock. Methods A retrospective study was made on the clinical data of 54 cases of acute renal failure from septic shock, the change of APACHEII scoring, serum level of electrolyte, blood gas analysis and mortality rate were statistically analyzed and evaluated. Results The SCr、BUN、K+、HCO3-、SaO2、CO2CP、HR、MAP、CVP and APACHEII were statistically different from the normal levels preoperatively(P<0.05).After CRRT treatment, the above index improved significantly(P<0.01). The mortality rate was 46.3%(25/54), the mortality rate reduced significantly after CRRT 4h after the onset than that 4h before(P=0.030). Conclusions CRRT can improve the hemodynamic status of the patients. The early application can reduce the mortality rate.%目的：总结分析连续性肾脏替代治疗（CRRT）感染性休克致急性肾功能衰竭的临床疗效。方法回顾性分析54例感染性休克致急性肾功能衰竭患者的临床资料，统计分析患者治疗前后APACHEII评分、血清电解质、血气分析结果，以及病死率等指标的变化。结果治疗前患者SCr、BUN、K+、HCO3-、SaO2、CO2CP、HR、MAP、CVP和APACHEII评分与正常水平差异均有统计学意义（P<0.05），经CRRT治疗后，上述指标明显改善，与治疗前相比差异有统计学意义（P<0.01）。病死率46.3%（25/54），发病4h后行CRRT的病死率显著低于发病后4h前的病死率（P=0.030）。结论 CRRT能够在短时间内改善患者的血流动力学状态，早期应用CRRT治疗能够降低病死率。