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目的探究持续血液滤过用于脓毒血症急性肾衰竭患者治疗的临床疗效。方法选取在重症监护室接受治疗的120例脓毒血症急性肾衰竭患者,随机分为观察组和对照组,每组60例。两组患者均给予常规治疗,观察组在常规治疗基础上给予静脉血液滤过(CVVH)治疗,对照组在常规治疗基础上给予静脉血液透析滤过(CVVHDF)治疗,比较两组患者在治疗前、治疗后5d的各项指标以及APACHEII评分,同时对比两组患者的住院相关指标。结果两组患者在治疗前及治疗后5 d的心率、呼吸、动脉压比较无显著差异(P>0.05);两组患者在治疗5 d后的肌酐、β2-微球蛋白水平、血尿素氮、炎症因子以及APACHEII评分显著优于治疗前的指标,治疗前后差异显著(P<0.05);观察组患者在治疗5 d后β2-微球蛋白水平显著优于对照组患者(P<0.05),具有统计学意义;两组患者的住院相关指标无显著差异(P>0.05)。结论脓毒血症急性肾衰竭患者采用持续血液滤过治疗临床效果显著,而给予静脉血液滤过治疗模式要比静脉血液透析滤过治疗模式更加有利于患者肾功能的恢复,值得临床推广和应用。
Objective To investigate the clinical efficacy of continuous hemofiltration in the treatment of patients with acute renal failure with sepsis. Methods A total of 120 patients with acute renal failure with sepsis treated in intensive care unit were randomly divided into observation group and control group, 60 cases in each group. The patients in both groups were given routine treatment. The observation group was given routine venous hemofiltration (CVVH) on the basis of routine treatment. The control group was given routine hemodialysis (CVVHDF) treatment on the basis of routine treatment. Before the treatment, , 5d after treatment and APACHEII score, at the same time compared the hospital-related indicators of two groups of patients. Results There were no significant differences in heart rate, respiration and arterial pressure between the two groups before treatment and 5 days after treatment (P> 0.05). Creatinine, β2-microglobulin, blood urea nitrogen , Inflammatory factors and APACHEII score were significantly better than those before treatment, the difference was significant (P <0.05) before and after treatment; β2-microglobulin level in the observation group was significantly better than that in the control group after 5 days of treatment (P <0.05) There was no significant difference between the two groups (P> 0.05). Conclusions Continuous hemofiltration is an effective treatment for patients with acute renal failure due to sepsis. However, the treatment of venous hemofiltration is more beneficial to the recovery of renal function than intravenous hemodiafiltration, which is worthy of clinical promotion and application .