实用临床医药杂志2024，Vol.28Issue(21)：66-69,76,5.DOI:10.7619/jcmp.20241850
连续性肾脏替代治疗应用时机对脓毒性休克集束化治疗患者疗效及预后的影响
Impact of timing of continuous renal replacement therapy on the efficacy and prognosis of patients with septic shock undergoing bundle therapy
摘要
Abstract
Objective To investigate the impact of the timing of continuous renal replacement therapy(CRRT)on the efficacy and prognosis of patients with septic shock undergoing bundle thera-py.Methods A total of 84 patients with septic shock who underwent bundle therapy were enrolled,receiving bundle therapy.Based on the timing of CRRT,the patients were divided into early CRRT group and late CRRT group,with 42 patients in each group.Clinical data(heart rate,time to normali-zation of body temperature,ICU length of stay)and infection status[C-reactive protein(CRP),procal-citonin(PCT)]and immune function(CD4+,CD8+,CD14+),as well as the Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)scores before and after treatment were compared between the two groups.The 28-day survival of patients in both groups was also followed up.Results The heart rate in the early CRRT group was lower than that in the late CRRT group,and the time to nor-malization of body temperature and ICU length of stay were shorter in the early CRRT group compared with the late CRRT group(P＜0.05).After treatment,the levels of CRP and PCT in both groups were lower than those before treatment,and their levels in the early CRRT group were lower than those in the late CRRT group(P＜0.05).After treatment,the levels of CD8+in both groups were lower than those before treatment,and the early CRRT group had lower level than that in the late CRRT group(P＜0.05);after treatment,the levels of CD4+and CD14+in both groups were higher than those before treatment,and their levels in the early CRRT group were higher than those in the late CRRT group(P＜0.05).After treatment,the APACHE Ⅱ scores of both groups were lower than those before treatment,and the early CRRT group had lower APACHE Ⅱ score than that in the late CRRT group(P＜0.05).The follow-up results showed that the 28-day cumulative survival rate was 83.33％(35/42)in the early CRRT group,which was higher than 64.29％(27/42)in the late CRRT group(P＜0.05).Conclusion For patients with septic shock undergoing bundle therapy,early application of CRRT is superior to late application in clinical efficacy,and contributes to im-proving the prognosis of patients.关键词
连续性肾脏替代治疗/脓毒性休克/集束化治疗/血液净化/疗效/预后Key words
continuous renal replacement therapy/septic shock/bundle therapy/blood pur-ification/efficacy/prognosis分类
医药卫生引用本文复制引用
朱翔宇,石岩,付婧..连续性肾脏替代治疗应用时机对脓毒性休克集束化治疗患者疗效及预后的影响[J].实用临床医药杂志,2024,28(21):66-69,76,5.基金项目
江苏省自然科学基金资助项目(FK2021GH266) （FK2021GH266）
