摘要
目的 分析老年重症肺炎合并急性肾损伤患者采取连续肾脏替代疗法(continuous renal replacement therapy, CRRT)诊疗的临床效果。方法 方便选择2019年8月—2021年8月于福建省级机关医院进行治疗的72例老年重症肺炎合并急性肾损伤患者,按奇偶法原则分组,对照组36例采取常规疗法,治疗组36例在对照组基础上采取CRRT,对比两组治疗效果。结果治疗后,治疗组尿素氮(14.06±4.56)mmol/L、血肌酐(251.03±26.22)μmol/L及血尿酸(182.36±65.26)μmol/L均比对照组(23.05±6.22)mmol/L、(321.83±22.66)μmol/L、(246.53±78.68)μmol/L低,差异有统计学意义(t=6.994、12.258、3.766,P<0.001)。相较于对照组,治疗组治疗后血清降钙素原、白介素-6、C反应蛋白水平明显均降低,差异有统计学意义(t=6.161、3.068、11.365,P<0.05)。治疗组病死率(11.11%)、多器官功能障碍综合征发生率(2.78%)均比对照组(36.11%、22.22%)低,差异有统计学意义(χ^(2)=6.237、4.571,P<0.05)。治疗组收缩压、舒张压及尿量均较对照组高,差异有统计学意义(t=2.517、5.061、7.323,P<0.05)。治疗组治疗后TLR2水平(4.02±2.03)mmol/L、TLR4水平(2.03±0.42)μmol/L均比对照组(7.18±1.29)mmol/L、(4.03±0.47)μmol/L低,差异有统计学意义(t=7.883、19.038,P<0.001)。结论老年重症肺炎合并急性肾损伤患者采取CRRT诊疗效果可观,有益于改善其肾功能,降低炎性因子表达,且提高患者生存率。
Objective To analyze the clinical effect of continuous renal replacement therapy (CRRT) diagnosis and treatment in elderly patients with severe pneumonia complicated with acute kidney injury.Methods A total of 72 elderly patients with severe pneumonia complicated by acute kidney injury in the Fujian Provincial Governmental Hospital were conveniently selected from August 2019 to August 2021.They were divided into groups according to the principle of odd-even method.36 patients in the control group received conventional therapy,and 36 patients in the treatment group received CRRT on the basis of the control group.Compared the treatment effect between the two groups.Results After treatment,the blood urea nitrogen (14.06±4.56) mmol/L,serum creatinine (251.03±26.22)μmol/L and blood uric acid (182.36±65.26)μmol/L in the treatment group were lower than those in the control group (23.05±6.22) mmol/L,(321.83±22.66)μmol/L,(246.53±78.68)μmol/L,the difference was statistically significant (t=6.994,12.258,3.766,P<0.001).Compared with the control group,the serum calci progenitor,interleukin-6,and C-reactive protein in the treatment group were significantly reduced,the difference was statistically significant (t=6.161,3.068,11.365,P<0.05).The mortality rate of the treatment group was 11.11%,and the multiple organ dysfunction syndrome rate was 2.78%were lower than those of the control group (36.11%,22.22%),the difference was statistically significant (χ^(2)=6.237,4.571,P<0.05).The systolic blood pressure,diastolic blood pressure and urine volume in the treatment group were higher than those in the control group,the difference was statistically significant (t=5.061,2.517,7.323,P<0.05).The levels of TLR2 (4.02±2.03) mmol/L and TLR4 (2.03±0.42)μmol/L in the treatment group were lower than those in the control group (7.18±1.29) mmol/L and (4.03±0.47)μmol/L,the difference was statistically significant (t=7.883,19.038,P<0.001).Conclusion CRRT has a considerable effect in the diagnosis and treatment of elderly patients with severe pneumonia complicated by acute kidney injury,which is beneficial to improve renal function,reduce the expression of inflammatory factors,and improve the survival rate of patients,which is worthy of reference.
作者
郑晓栗
暨永亮
林捷
ZHENG Xiaoli;JI Yongliang;LIN Jie(Department of Emergency and Critical Care,Fujian Provincial Governmental Hospital,Fuzhou,Fujian Province,350000 China)
出处
《中外医疗》
2022年第30期31-34,43,共5页
China & Foreign Medical Treatment
关键词
老年重症肺炎
急性肾损伤
连续肾脏替代疗法
肾功能
炎性因子
Severe pneumonia in the elderly
Acute kidney injury
Continuous renal replacement therapy
Renal function
Inflammatory factors
