论文部分内容阅读
目的探讨AKIN分期在创伤后急性肾损伤(AKI)患者进行连续性肾脏替代治疗(CRRT)时机选择中的应用价值。方法创伤后AKI患者84例按AKIN标准分为1期(32例)、2期(22例)和3期(30例)。均采用CRRT治疗,检测治疗前和治疗24h后APACHEⅡ评分、氧合指数、血清肌酐、血尿素氮、血钾和血乳酸值,比较三组患者的病死率。结果 AKIN 3期组患者病死率为80.0%(24/30),AKIN 2期组病死率为68.2%(15/22),均明显高于AKIN 1期组的37.5%(12/32)(P<0.05)。CRRT治疗24h后,三组患者APACHEⅡ评分、血清肌酐、血尿素氮和血钾均明显下降(P<0.05);治疗24h后,AKIN 1期患者的氧合指数显著升高、血乳酸值显著降低(P<0.05),但在AKIN 2、3期患者则无明显变化。结论 AKIN标准对创伤后AKI患者的早期诊断和预后判断有重要指导意义。
Objective To investigate the value of AKIN staging in the timing of continuous renal replacement therapy (CRRT) in patients with acute renal injury (AKI) after trauma. Methods 84 patients with AKI after traumatic injury were divided into 1 phase (32 cases), 2 cases (22 cases) and 3 stages (30 cases) according to AKIN standard. CRRT was used to detect the APACHEⅡscore, oxygenation index, serum creatinine, blood urea nitrogen, serum potassium and blood lactate before and 24 hours after treatment. The mortality of three groups were compared. Results The case fatality rate was 80.0% (24/30) in AKIN stage 3 patients and 68.2% (15/22) in AKIN stage 2 patients, which was significantly higher than that in AKIN stage 1 patients (37.5%, P <0.05). After 24h of CRRT treatment, APACHEⅡscore, serum creatinine, blood urea nitrogen and serum potassium in the three groups were significantly decreased (P <0.05); After 24h treatment, the oxygenation index of patients in AKIN 1 group increased significantly, (P <0.05), but there was no significant change in AKIN stage 2,3 patients. Conclusion AKIN standard has important guiding significance for early diagnosis and prognosis of post-traumatic AKI.