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目的对比观察采用持续低效血液透析(SLED)与连续性肾脏替代治疗(CRRT)治疗感染性急性肾损伤(Septic AKI)的效果。方法选择入住重症加强护理病房且资料完整的Septic AKI 2期患者57例,按照治疗方法的不同随机分为SLED组30例及CRRT组27例。比较2组患者治疗前及治疗48h后急性生理和慢性健康状况Ⅱ(APACHEⅡ)评分、序贯器官衰竭估计(SOFA)评分、血钾、平均动脉压(MAP)、血肌酐(Scr)、氧合指数(OI)、血尿素(BUN)、尿量(UO)、血乳酸(Lac),患者28d及90d的生存状况、病死率,以及住ICU时间和机械通气时间。结果经过48h的治疗,2组患者的Scr、BUN、K+、MAP、OI、Lac、UO、APACHEⅡ及SOFA评分均较治疗前明显好转(P<0.05)。2组机械通气时间、住ICU时间以及28d、90d病死率比较差异均无统计学意义(P>0.05)。结论 Septic AKI患者采用SLED或CRRT均有效,SLED可一定程度上替代CRRT,成为治疗Septic AKI患者的有效方式。
Objective To compare the efficacy of continuous low inefficient hemodialysis (SLED) and continuous renal replacement therapy (CRRT) in the treatment of septic AKI. Methods Fifty-seven patients with Septic AKI stage 2 who were admitted to intensive care unit and complete data were randomly divided into three groups: 30 in the SLED group and 27 in the CRRT group according to the different treatment methods. Acute physiology and chronic health status Ⅱ (APACHEⅡ) score, sequential organ failure assessment (SOFA) score, serum potassium, mean arterial pressure (MAP), serum creatinine (Scr) (OI), blood urea nitrogen (BUN), urine volume (UO), blood lactic acid (Lac), patients 28d and 90d survival status, mortality, and live ICU time and mechanical ventilation time. Results After 48 hours of treatment, the scores of Scr, BUN, K +, MAP, OI, Lac, UO, APACHEⅡ and SOFA in both groups were significantly improved compared with those before treatment (P <0.05). There was no significant difference in the two groups of mechanical ventilation time, ICU time, and 28d, 90d mortality (P> 0.05). Conclusions Both Seled AKI and SLED are effective with SLED or CRRT, and SLED can replace CRRT to a certain extent. It is an effective way to treat Septic AKI.