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目的探讨连续性血液净化(CBP)治疗不同分期脓毒症所致急性肾损伤(AKI)的临床疗效。方法选取2012年7月—2014年11月莆田学院附属医院收治的98例脓毒症所致AKI患者,根据AKI分期分为A组(Ⅰ~Ⅱ期,n=43)和B组(Ⅲ期,n=55);根据治疗前24 h尿量分为非少尿组32例与少尿组66例。所有患者行CBP治疗,比较A组与B组患者治疗前及治疗后1、3、7 d急性生理学与慢性健康状况(APACHEⅡ)评分,比较非少尿组与少尿组患者肾功能恢复及死亡情况。结果 A组患者总体APACHEⅡ评分低于B组(F总=0.83,P<0.05),其中不同时间比较,差异有统计学意义(F时间=0.23,P<0.05),不同组间比较,差异有统计学意义(F组别=1.65,P<0.05),时间与组间存在交互作用(F交互=1.89,P<0.05)。非少尿组患者肾功能恢复13例、死亡10例,少尿组患者肾功能恢复13例、死亡36例,非少尿组患者肾功能恢复率高于少尿组,病死率低于少尿组,差异均有统计学意义(χ2值分别为4.89、4.69,P<0.05)。结论 CBP治疗Ⅰ~Ⅱ期AKI患者的临床疗效优于Ⅲ期AKI患者,非少尿AKI患者预后优于少尿AKI患者。
Objective To investigate the clinical effect of continuous blood purification (CBP) on acute kidney injury (AKI) induced by sepsis in different stages. Methods A total of 98 patients with AKI induced by sepsis were selected from July 2012 to November 2014 in the Affiliated Hospital of Putian University and divided into group A (stage Ⅰ ~ Ⅱ, n = 43) and group B , n = 55). According to the amount of urine before 24 hours of treatment, there were 32 cases in non-oliguria group and 66 cases in oliguria group. All patients underwent CBP treatment. The acute physiology and chronic health status (APACHEⅡ) scores of patients in group A and group B before and after treatment were compared, and the recovery and death of renal function in non-oliguria group and oliguria group were compared Happening. Results The overall score of APACHEⅡ in group A was lower than that in group B (F = 0.83, P <0.05), and the difference was statistically significant at different times (F = 0.23, P <0.05) Statistical significance (F = 1.65, P <0.05), there was interaction between time and group (F interaction = 1.89, P <0.05). In the non-oliguric group, 13 cases were recovered with renal function, 10 cases were killed, 13 cases were recovered with renal function in oliguria group, and 36 cases died. The recovery rate of renal function in non-oliguric group was higher than that in oliguria group, Group, the differences were statistically significant (χ2 values were 4.89,4.69, P <0.05). Conclusion The clinical efficacy of CBP in stage Ⅰ ~ Ⅱ AKI patients is better than that of stage Ⅲ AKI patients. The prognosis of non-oliguric AKI patients is better than that of AKI patients.