连续血液透析滤过技术在小儿脓毒症合并急性肾损伤中的应用

目的：探讨连续血液透析滤过技术在脓毒症合并急性肾损伤患儿中的应用及治疗体会。方法乌鲁木齐市儿童医院重症医学科于2011年9月-2013年9月对15例脓毒症合并急性肾损伤患儿进行血液透析加滤过治疗，监测治疗前后患儿白细胞计数、肝功、肾功、PCT、CRP、血气分析等生化指标以及患儿尿量、水肿程度、临床症状体征的变化。结果15例患儿均顺利进行了中心静脉置管及血液透析滤过治疗，平均治疗时间为7．5 h （2～30 h），治疗48 h 后患儿尿量增加，水肿减轻，肝、肾功能、心肌酶、血气及 CRP、PCT 等炎症指标均有不同程度的改善，与治疗前相比各项指标差异均具有统计学意义（P ＜0．05）。结论对于脓毒症合并急性肾损伤患儿选择合适时机给予连续血液透析滤过治疗，可有效改善肾功能，增加尿量，改善各项炎症指标及脏器功能，提高临床救治成功率。

The application of continuous hemodialysis filtration technology in the pediatric sepsis with acute kidney injury

Objective To explore the application of continuous hemodialysis filtration technology in the ped-iatric sepsis with acute kidney injury.Methods 15 cases of patients with sepsis with acute kidney injury in Department of Critical Care Medicine of Urumqi Children＇s Hospital in 2011.9- 2013.9 were given hemodi-alysis and filtration treatment,and their biochemical indicators,including white blood cells,hepatic func-tion,renal function,PCT,CRP,blood gas analysis,and their clinical symptoms in urine output and the degree of edema were monitored before and after the treatment.Results The central venous catheter and hemodialysis filtration treatment were smoothly conducted in 15 cases,with the average treatment time 7.5 h （2-30 h）.The conditions of patients were obviously improved in 48 hours after the treatment,with urine output increaseing,edema relieving,the function of liver and kidney bettering,the indices of myocardium enzyme,blood gas,CRP and PCT inflammation improving to different degree.Each index after the treatment was statistically sig-nificant,when compared with those before the treatment （P〈0.05）.Conclusion The continuous hemodialysis filtration treatment given to the children with sepsis with acute kidney injury in appropriate time can effec-tively improve the kidney function,increase urine output and improve the inflammatory indices and the viscera function,which can improve the success rate of clinical treatment.