临床和实验医学杂志
臨床和實驗醫學雜誌
림상화실험의학잡지
JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE
2015年
7期
548-550
,共3页
连续性肾脏替代治疗%液体平衡%急性肾损伤
連續性腎髒替代治療%液體平衡%急性腎損傷
련속성신장체대치료%액체평형%급성신손상
Continuous renal replacement therapy%Fluid balance%Acute Kidney injury
目的：探讨连续性肾脏替代治疗对患者容量负荷及预后的影响。方法选取2012年6月至2013年10月住院肾脏替代治疗的危重患者伴有急性肾损伤88例为研究对象，分为连续性肾脏替代治疗组（CRRT 组，58例）和普通治疗组（非 CRRT 组，30例）；将58例连续性肾脏替代治疗的患者分为液体负平衡组（38例）和液体正平衡（20例）。观察对比其容量负荷和预后情况及之间的关系。结果 CRRT 组的日平均容量、APACHEⅡ评分、30 d 病死率及住 ICU时间均小于非 CRRT 组，差异有统计学意义（ P <0.05）；液体负平衡组的 APACHEⅡ评分、30 d 病死率及住 ICU 时间均小于液体正平衡组，差异有统计学意义（ P <0.05）；CRRT 患者日平均容量>500 ml 组的 APACHEⅡ评分、病死率均明显高于0~300 ml 组及300~500 ml 组，差异有统计学意义（ P <0.05）。结论应用 CRRT 治疗危重患者伴有急性肾损伤的疗效及预后优于普通治疗组，在进行 CRRT 时，合理地控制容量的摄入可以提高临床疗效及预后。
目的：探討連續性腎髒替代治療對患者容量負荷及預後的影響。方法選取2012年6月至2013年10月住院腎髒替代治療的危重患者伴有急性腎損傷88例為研究對象，分為連續性腎髒替代治療組（CRRT 組，58例）和普通治療組（非 CRRT 組，30例）；將58例連續性腎髒替代治療的患者分為液體負平衡組（38例）和液體正平衡（20例）。觀察對比其容量負荷和預後情況及之間的關繫。結果 CRRT 組的日平均容量、APACHEⅡ評分、30 d 病死率及住 ICU時間均小于非 CRRT 組，差異有統計學意義（ P <0.05）；液體負平衡組的 APACHEⅡ評分、30 d 病死率及住 ICU 時間均小于液體正平衡組，差異有統計學意義（ P <0.05）；CRRT 患者日平均容量>500 ml 組的 APACHEⅡ評分、病死率均明顯高于0~300 ml 組及300~500 ml 組，差異有統計學意義（ P <0.05）。結論應用 CRRT 治療危重患者伴有急性腎損傷的療效及預後優于普通治療組，在進行 CRRT 時，閤理地控製容量的攝入可以提高臨床療效及預後。
목적：탐토련속성신장체대치료대환자용량부하급예후적영향。방법선취2012년6월지2013년10월주원신장체대치료적위중환자반유급성신손상88례위연구대상，분위련속성신장체대치료조（CRRT 조，58례）화보통치료조（비 CRRT 조，30례）；장58례련속성신장체대치료적환자분위액체부평형조（38례）화액체정평형（20례）。관찰대비기용량부하화예후정황급지간적관계。결과 CRRT 조적일평균용량、APACHEⅡ평분、30 d 병사솔급주 ICU시간균소우비 CRRT 조，차이유통계학의의（ P <0.05）；액체부평형조적 APACHEⅡ평분、30 d 병사솔급주 ICU 시간균소우액체정평형조，차이유통계학의의（ P <0.05）；CRRT 환자일평균용량>500 ml 조적 APACHEⅡ평분、병사솔균명현고우0~300 ml 조급300~500 ml 조，차이유통계학의의（ P <0.05）。결론응용 CRRT 치료위중환자반유급성신손상적료효급예후우우보통치료조，재진행 CRRT 시，합리지공제용량적섭입가이제고림상료효급예후。
Objective To explore the influence of volume load on prognosis of critically ill patients with acute Kidney injury. Methods By using retrospective analysis,88 critically ill patients with acute Kidney injury treated in this hospital during June 2012 to October 2013 were chosen for this study,they were divided into CRRT(continuous renal replacement therapy)group(58 cases)and general treatment group(30 ca-ses). Fifty eight patients in CRRT group were divided into liquid balanced group(20 cases)and liquid unbalanced group(38 cases),the rela-tionship between capacity and prognosis had been analyzed. Results The average daily capacity,APACHEⅡscores,30 d fatality rate and times in ICU of patients in CRRT group were less than those of general treatment group,and the difference was statistically significant( P < 0. 05). The APACHEⅡscores,30d fatality rate and times in ICU of patients in liquid unbalanced group were less than those of liquid balanced group,and the difference was statistically significant( P < 0. 05). The relationship among average daily capacity,APACHEⅡscores and mortality was positively correlated( P < 0. 05). Conclusion The clinical efficacy and prognosis of critically ill patients with acute Kidney injury treated by CRRT are better than those with general treatment,and the reasonable control of liquid intaKe can improve the clinical curative effect and prognosis of these patients with CRRT.
