摘要
目的探讨早期连续性血液净化(CBP)在胃癌术后并发脓毒症急性肾损伤中的应用价值。方法纳入2018年1月至2020年12月收治的58例胃癌术后并发脓毒症急性肾损伤患者作为研究对象,遵循随机平均原则将其分为参照组和CBP组,各29例。参照组接受传统CBP治疗,CBP组接受早期CBP治疗。比较两组患者治疗前、治疗14 d后的C反应蛋白(CRP)、白细胞介素-18(IL-18)、白细胞介素-6(IL-6)、尿液中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、肝型脂肪酸结合蛋白(L-FABP)、尿液中肾损伤分子-1(KIM-1)水平、急性生理学及慢性健康状况评分Ⅱ(APACHEⅡ)评分及治疗14 d后的病情控制优良率。结果治疗14 d后,两组患者的CRP、IL-18、IL-6水平均较治疗前降低,且CBP组明显低于参照组,差异具有统计学意义(P<0.05)。治疗14 d后,两组患者的NGAL、L-FABP、KIM-1水平均较治疗前降低,且CBP组明显低于参照组,差异具有统计学意义(P<0.05)。CBP组患者治疗14 d后的病情控制优良率为93.10%,显著高于参照组的65.52%,差异具有统计学意义(P<0.05)。治疗14 d后,两组患者的APACHEⅡ评分均较治疗前降低,且CBP组明显低于参照组,差异具有统计学意义(P<0.05)。结论早期CBP用于胃癌术后并发脓毒症急性肾损伤患者中的效果更佳,可明显地改善炎症因子水平,有利于肾功能恢复,促进症状消退,还可有效地改善机体的急慢性健康状况,值得临床推广应用。
Objective To investigate the application value of early continuous blood purification(CBP)in patients with acute renal injury complicated with sepsis after gastric cancer surgery.Methods Fifty-eight patients with acute renal injury complicated with sepsis after gastric cancer surgery treated from January 2018 to December 2020 were included as the research objects.The patients were divided into reference group and CBP group according to the principle of random average,with 29 cases in each group.The reference group received traditional CBP treatment,and the CBP group received early CBP treatment.The levels of C-reactive protein(CRP),interleukin-18(IL-18),interleukin-6(IL-6),urinary neutrophil gelatinase associated lipocalin(NGAL),liver fatty acid-binding protein(L-FABP),kidney injury molecule-1(KIM-1)in urine,the score of acute physiology and chronic health evaluationⅡ(APACHEⅡ)before and 14 d after treatment,the excellent and good rate of disease control after 14 d of treatment were compared between the two groups.Results After 14 d of treatment,the levels of CRP,IL-18,IL-6 in both groups were lower than those before treatment,and those in the CBP group were significantly lower than the reference group,the differences were statistically significant(P<0.05).After 14 d of treatment,the levels of NGAL,L-FABP and KIM-1 in both groups were lower than those before treatment,and those in the CBP group were significantly lower than the reference group,the differences were statistically significant(P<0.05).The excellent and good rate of disease control after 14 d of treatment in the CBP group was 93.10%,which was significantly higher than 65.52%in the reference group,the difference was statistically significant(P<0.05).After 14 d of treatment,APACHEⅡscore in both groups was lower than that before treatment,and that in the CBP group was significantly lower than the reference group,the difference was statistically significant(P<0.05).Conclusion The early CBP applied in patients with acute renal injury complicated with sepsis after gastric cancer surgery is more effective.It can significantly improve inflammatory factors levels,facilitate the recovery of renal function,promote the regression of symptoms,and effectively improve the acute and chronic health status of the body,which is worthy of clinical promotion and application.
作者
祝云鹤
吴召利
崔旭
刘璐
李仁廷
魏巧妙
王博
ZHU Yunhe;WU Zhaoli;CUI Xu;LIU Lu;LI Renting;WEI Qiaomiao;WANG Bo(Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000,China)
出处
《临床医学研究与实践》
2022年第5期38-41,共4页
Clinical Research and Practice
关键词
胃癌
脓毒症
急性肾损伤
早期连续性血液净化
传统连续性血液净化
肾功能
gastric cancer
sepsis
acute renal injury
early continuous blood purification
traditional continuous blood purification
renal function
