摘要
目的 分析高流量血液滤过治疗重症加强护理病房(ICU)感染性休克合并急性肾损伤的临床效果.方法 96 例ICU感染性休克合并急性肾损伤患者,随机分为观察组和对照组,每组 48 例.对照组给予肾脏替代疗法治疗,观察组采用高流量血液滤过治疗.比较两组患者输液量、去甲肾上腺素使用量、肾小管损伤情况及患者和家属对治疗的满意度评分.结果 观察组上机 12、24、36 h输液量和去甲肾上腺素使用量分别为(36.21±13.23)、(51.11±16.65)、(45.27±9.19)g/(kg·min)和(1.19±0.21)、(1.03±0.21)、(0.35±0.27)μg/(kg·min),对照组分别为(95.08±12.26)、(102.34±13.79)、(108.34±16.16)g/(kg·min)和(1.39±0.28)、(1.31±0.11)、(1.28±0.45)μg/(kg·min);观察组上机 12、24、36 h输液量、去甲肾上腺素使用量显著少于对照组,对比存在统计学意义(P<0.05).观察组患者肾小管损伤情况优于对照组,对比存在统计学意义(P<0.05).观察组患者及其家属对治疗的日常行为、控制行为、处理行为、监测行为评分及总分分别为(24.3±4.5)、(31.4±4.8)、(19.6±3.6)、(12.5±3.8)、(87.8±10.8)分,均高于对照组的(15.1±3.2)、(16.0±5.9)、(11.2±2.7)、(6.3±2.1)、(48.6±8.9)分,对比存在统计学意义(P<0.05).结论 应用高流量血液滤过治疗ICU感染性休克合并急性肾损伤患者效果显著,有利于降低输液量、去甲肾上腺素使用量及肾小管损伤程度,对维持良好的医患关系也具有积极意义,值得今后推广.
Abstract
Objective To analyze the clinical effect of high flow hemofiltration in the treatment of septic shock complicated with acute kidney injury in intensive care unit(ICU).Methods 96 patients with septic shock and acute kidney injury in ICU were randomly divided into an observation group and a control group,with 48 patients in each group.The control group was given renal replacement therapy,and the observation group was given high flow hemofiltration.The infusion volume,norepinephrine use,renal tubular injury,and satisfaction scores of patients and their families of the two groups were observed and compared.Results At 12,24,and 36 h after the start of hemofiltration,the infusion volume and norepinephrine use in the observation group were(36.21±13.23),(51.11±16.65),(45.27±9.19)g/(kg·min),and(1.19±0.21),(1.03±0.21),(0.35±0.27)μg/(kg·min),and those in the control group were(95.08±12.26),(102.34±13.79),(108.34±16.16)g/(kg·min)and(1.39±0.28),(1.31±0.11),(1.28±0.45)μg/(kg·min).At 12,24,and 36 h after the start of hemofiltration,the infusion volume and norepinephrine use in the observation group were significantly lower than those in the control group,and there was statistical significance(P<0.05).The renal tubule injury in the observation group was better than that in the control group,and there was statistical significance(P<0.05).The scores of daily behavior,control behavior,processing behavior and monitoring behavior and total scores of patients and their families in the observation group were(24.3±4.5),(31.4±4.8),(19.6±3.6),(12.5±3.8)and(87.8±10.8)points,which were higher than(15.1±3.2),(16.0±5.9),(11.2±2.7),(6.3±2.1)and(48.6±8.9)points in the control group,and there was statistical significance(P<0.05).Conclusion The application of high flow hemofiltration in the treatment of septic shock patients with acute kidney injury in ICU has significant effects,which is conducive to reducing the infusion volume,the use of norepinephrine and the degree of renal tubule injury,and has positive significance for maintaining a good doctor-patient relationship,which is worthy of future promotion.
维普
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