中国伤残医学2025，Vol.33Issue(2)：10-15,6.DOI:10.13214/j.cnki.cjotadm.2025.002.003
血液灌流联合连续性静脉-静脉血液滤过治疗脓毒性休克并发早期急性肾损伤患者的效果评价
Evaluation of the Therapeutic Effect of Hemoperfusion Combined with Continuous Veno-Venos Hemofiltration in the Treatment of Patients with Septic Shock Complicated with Early Acute Kidney Injury
摘要
Abstract
Objective:To investigate the effects of hemoperfusion(HP)combined with continuous veno-venous hemofiltration(CVVH)on renal function,other organ function and prognosis in patients with septic shock complicated with early sepsis related acute kidney injury(SA-AKI).Methods:Clinical data of 96 patients with septic shock complicated with early SA-AKI admitted to Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine from January 2023 to June 2024 were retrospectively analyzed,and they were divided into a single CVVH group and a HP combined CVVH group,with 48 cases in each group,according to whether they were treated with HP or not.The two groups were treated with conventional sepsis.The single CVVH group was treated with CVVH for 72 h,and the HP combined with CVVH group was treated with HP combined with the single CVVH group.The inflammation and coagulation function indexes,renal function and other organ function recovery indexes,prognostic indexes were compared between the two groups.Results:The rate of mechanical ventilation and the incidence of adverse events in HP combined CVVH group were 60.42%and 20.83%,respectively,compared with 58.33%and 16.67%in the single HP group,there were no significant differences(P>0.05).The mechanical ventilation time and ICU stay time of HP combined CVVH group were shorter than those of single CVVH group,the case fatality rate within 28 d was 35.42%,which was lower than that of single CVVH group,and the renal function recovery rate within 90 d was 68.75%,which was higher than that of single CVVH group,with statistical significance(P<0.05).After 48 h of treatment,serum creatinine,serum lactate,norepinephrine dosage and Sequential Organ Failure Assessment scores in both groups were lower those before treatment and after 24 h of treatment,and HP combined CVVH group were lower than the single CVVH group,oxygenation index value,Acute Physiology and Chronic Health EvaluationⅡ scores in both groups were higher than those before treatment and after 24 h of treatment,the HP combined CVVH group were higher than the single CVVH group,the differences were statistically significant(P<0.05).After 48 h of treatment,the average levels of interleukin-6 and calcitonin in the two groups were lower than before treatment and 24 h after treatment,and the HP combined CVVH group were lower than the single CVVH group,the levels of platelet count and peripheral blood lymphocyte count in the two groups were higher than those before treatment and 24 h after treatment,and the HP combined CVVH group were higher than the single CVVH group,the differences were statistically significant(P<0.05).Conclusions:In septic shock patients with early SA-AKI,HP combined with CVVH may reduce the level of inflammatory mediators,improve coagulation function and renal hemodynamics,improve organ function score,and ultimately increase the 90-day renal function recovery rate and reduce the 28-day mortality,and improve the prognosis.关键词
脓毒性休克/急性肾损伤/血液灌流/血液滤过Key words
Hemoperfusion/Hemofiltration/septic shock/Acute kidney injury/Sequential organ failure assessment分类
临床医学引用本文复制引用
王华敏,徐保平,黄书哲,汪得利,刘八一..血液灌流联合连续性静脉-静脉血液滤过治疗脓毒性休克并发早期急性肾损伤患者的效果评价[J].中国伤残医学,2025,33(2):10-15,6.基金项目
2022年广东省医学科学技术研究(A2022546) （A2022546）
