目的:探讨连续性肾脏替代治疗(Continuous renal replacement therapy,CRRT)对脓毒症所致急性肾损伤(Acute kidney injury,AKI)患者糖代谢、尿量和肾血流的影响.方法:选取 2022年 3 月至 2023年 5 月于我院进行治疗的 86 例脓毒症所致AKI患者作为研究对象,按照随机数字表法将患者分为对照组和观察组,各 43 例.所有患者均接受抗感染等常规治疗方法.在此基础上,对照组采用间歇性血液透析治疗;观察组采用CRRT治疗.分析比较两组的糖代谢、预后情况和肾血流动力学.结果:治疗前,两组空腹血糖(Fasting blood glucose,FBG)、餐后 2 h血糖(2h Postprandial blood glucose,2PBG)、肾血流峰值强度、曲线下面积(Area under the curve,AUC)、平均渡越时间均无明显差异(P＞0.05);两组FPG、2PBG相较于治疗前均明显降低(P＜0.05),且观察组明显低于对照组(P＜0.05);观察组的尿量恢复时间、重症监护室(Intensive care unit,ICU)住院时间、器官支持时间均显著短于对照组(P＜0.001);两组的肾血流峰值强度、AUC、平均渡越时间均明显上升(P＜0.05),且观察组明显高于对照组(P＜0.05).结论:CRRT可有效改善脓毒症所致AKI患者糖代谢、尿量和肾血流.
Effect of continuous renal replacement therapy on patients with acute renal injury caused by sepsis
Objective:To investigate the effects of Continuous renal replacement therapy(CRRT)on glucose metabolism,urine volume and renal blood flow in patients with Acute kidney injury(AKI)caused by sepsis.Methods:A total of 86 patients with sepsis induced AKI who were treated in our hospital from March 2022 to May 2023 were selected as research objects,and were divided into control group and observation group according to random number table method,with 43 cases in each group.All patients received anti-infection and other conventional treatments.On this basis,the control group received intermittent hemodialysis treatment;Observation group was treated with CRRT.The glucose metabolism,prognosis and renal hemodynamics of the two groups were analyzed and compared.Result:Before treatment,Fasting blood glucose(FBG),2h Postprandial blood glucose(2PBG),peak renal blood flow intensity,Area under the curve,There were no significant differences in AUC and mean transit time(P>0.05).FPG and 2PBG in both groups were significantly lower than before treatment(P<0.05),and the observation group was significantly lower than the control group(P<0.05).Urine volume recovery time,Intensive care unit(ICU)stay time and organ support time in observation group were significantly shorter than those in control group(P<0.001).The peak renal blood flow intensity,AUC and mean transit time of both groups were significantly increased(P<0.05),and the observation group was significantly higher than the control group(P<0.05).Conclusion:CRRT can effectively improve glucose metabolism,urine volume and renal blood flow in patients with sepsis induced AKI.
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万方数据
维普
