连续性肾脏替代治疗脓毒症急性肾损伤的研究现状

急性肾损伤是临床常见的并发症,其发病率在逐年增加,在重症监护病房脓毒症所引起急性肾损伤占30%～50%,其病死率最高可达70%。近年来尽管对脓毒症急性肾损伤的认识及治疗方面取得了许多重大进步,特别是在重症监护病房连续性肾脏替代治疗广泛用于脓毒症急性肾损伤的治疗,但是其预后没有实质性改变,其病死率仍在不断增长,原因可能是对脓毒症急性肾损伤的发病机制了解不够深入,未采取及时有效的治疗措施。该文对脓毒症急性肾损伤的发病机制及其连续性肾脏替代治疗的时机、剂量、抗凝研究现状作一综述。

The Research of Continuous Renal Replacement Therapy in Sepsis Related Acute Kidney Injury

Acute kidney injury(AKI) is a common complication with increasing incidence in clinical every year,sepsis caused acute kidney injury accounts for 30%-50% and the mortality can be as high as 70% in ICU.In recent years,significant progress in the understanding and treatment of sepsis caused acute kidney injury has been made,especially CRRT is widely used in sepsis AKI in ICU,but its prognosis doesn't change,and the mortality rate is still growing,the reason may be not deep enough understanding of the pathogenesis of sepsis AKI and failure in delivering timely and effective treatment.Here is to make a view of the pathogenesis of sepsis AKI and the CRRT timing,dose,and anticoagulation research.