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目的探讨血液净化治疗感染性休克伴急性肾损伤的临床效果。方法选取2013年1月至2015年12月感染性休克伴急性肾损伤患者104例,根据血液净化方式将患者分为两组,IHD组59例行间歇性血液透析,CBP组45例行连续性血液净化。比较两组血液指标及急性生理和慢性健康状况(APACHEⅡ)评分。结果治疗后7 d,心率,血清肌酐、尿素氮、肿瘤坏死因子-α、白细胞介素-6、APACHEⅡ评分CBP组低于IHD组,差异有统计学意义(P<0.05)。ICU住院时间CBP组短于IHD组,差异有统计学意义(P<0.05)。两组总住院时间、住院死亡和出院后6个月内死亡,比较差异未见统计学意义(P>0.05)。结论连续性血液净化治疗感染性休克伴急性肾损伤早期效果较好。
Objective To investigate the clinical efficacy of blood purification in the treatment of septic shock with acute renal injury. Methods From January 2013 to December 2015,104 patients with septic shock and acute kidney injury were divided into two groups according to the method of blood purification. Fifty-nine patients in IHD group received intermittent hemodialysis and 45 patients in CBP group received continuous Blood purification. The blood parameters and acute physiology and chronic health status (APACHEⅡ) scores of the two groups were compared. Results At 7 days after treatment, heart rate, serum creatinine, blood urea nitrogen, tumor necrosis factor-α, interleukin-6 and APACHEⅡscore CBP group were lower than IHD group (P <0.05). ICU length of stay CBP group shorter than IHD group, the difference was statistically significant (P <0.05). The two groups of total hospital stay, hospital deaths and death within 6 months after discharge, the difference was not statistically significant (P> 0.05). Conclusion Continuous blood purification in the treatment of septic shock with acute renal injury early effect is better.