CRRT联合白蛋白治疗危重症合并急性肾衰竭的疗效观察

目的:探讨CRRT联合白蛋白治疗危重症合并急性肾衰竭的临床疗效。方法:选择我院2016年8月~2018年7月间收治的危重症合并急性肾衰竭患者84例,随机分为对照组和观察组,各42例。观察组采用24h CRRT联合人血白蛋白治疗,对照组采用CRRT治疗,比较两组治疗前后ALB、BUN、SCr、IL-6、K+变化及并发症发生率情况。结果:治疗前,两组ALB、BUN、SCr、IL-6及K+水平比较差异无统计学意义(P>0.05);治疗后,两组ALB水平均升高,BUN、SCr、IL-6及K+水平均降低(P<0.05);观察组治疗后ALB水平高于对照组,BUN、SCr、K+水平低于对照组(P<0.05),两组IL-6水平比较无明显差异(P>0.05);观察组急性ARDS、多器官出血、渗出性肺炎发生率明显低于对照组(P<0.05)。结论:CRRT联合白蛋白对维持危重症并急性肾衰竭患者水电解质平衡、改善肾功能及降低临床并发症方面的疗效显著,可临床推广应用。

Clinical Observation of CRRT Combined with Albumin in the Treatment of Critically Ill Patients with Acute Renal Failure

Objective:To investigate the clinical efficacy of CRRT combined with albumin in the treatment of critically ill patients with acute renal failure.Methods:84 critically ill patients with acute renal failure admitted to our hospital from August 2016 to July 2018 were randomly divided into control group and observation group,42 cases in each group.The observation group was treated with 24 hours CRRT combined with human albumin,while the control group was treated with CRRT.The changes of ALB,BUN,SCr,IL-6,K+and the incidence of complications were compared between the two groups before and after treatment.Results:Before treatment,there was no significant difference in ALB,BUN,SCr,IL-6 and K+levels between the two groups(P>0.05);After treatment,ALB levels in both groups increased,BUN,SCr,IL-6 and K+levels decreased(P<0.05);After treatment,ALB levels in the observation group were higher than those in the control group,BUN,SCr,K+levels were lower than those in the control group(P<0.05),and there was no significant difference in IL-6 levels between the two groups(P>0.05).The incidence of acute ARDS,multiple organ hemorrhage and exudative pneumonia was significantly lower than that of the control group(P<0.05).Conclusion:CRRT combined with albumin is effective in maintaining the balance of water and electrolyte,improving renal function and reducing clinical complications in critically ill patients with acute renal failure.It can be widely used in clinical practice.