| 张宁,林乐清.尿动力学指导脓毒症患者液体复苏对AKI发生的影响[J].浙江中西医结合杂志,2026,36(7): |
| 尿动力学指导脓毒症患者液体复苏对AKI发生的影响 |
| Influence of urodynamic device guidance of fluid resuscitation on acute renal injury |
| 投稿时间：2024-09-04 修订日期：2026-06-08 |
| DOI： |
| 中文关键词: 尿动力学装置 脓毒症 液体复苏 肾损伤 |
| 英文关键词:Urodynamic device Sepsis Fluid resuscitation Renal injury |
| 基金项目:杭州市医学重点学科基金项目，2023年杭州市生物医药和健康产业发展扶持科技专项基金 |
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| 中文摘要: |
| 目的 探究尿动力学装置指导脓毒症患者液体复苏后对急性肾损伤发生的影响。方法 选取我院重症监护室(ICU)的脓毒症患者60例,收治时间为2023年6月-2024年2月,随机分为对照组(n=30)和观察组(n=30),观察组入科留置尿动力学装置监测实时尿量,对照组留置常规性字母尿袋记录尿量,比较两组液体复苏6h、12h、24h的血肌酐(Scr)、尿素氮(BUN)、血清胱抑素C(CysC)水平,比较两组液体复苏6h、12h、24h的血乳酸(LaC)、中心静脉血氧饱和度(ScvO2),比较两组液体复苏12h、24h、48h的中心静脉压(CVP)、平均动脉压(MAP),比较两组ICU住院时间。结果 两组Scr、BUN、CysC、LaC、ScvO2、CVP、MAP水平的组间、时间点、交互差异均有统计学意义(P＜0.05)；液体复苏时间越长,Scr、BUN、CysC、LaC水平越低,且观察组低于对照组(P＜0.05),ScvO2、CVP、MAP水平越高,且观察组高于对照组(P＜0.05)；观察组的ICU住院时间低于对照组(P＜0.05)。结论 尿动力学装置指导脓毒症患者液体复苏,能够改善尿损伤生物学指标、血液循环情况和组织灌注情况,降低脓毒症相关急性肾损伤的发生,缩短患者的ICU住院时间。 |
| 英文摘要: |
| Objective To explore the influence of urodynamic device guidance for patients with sepsis after fluid resuscitation on renal injury. Methods 60 patients with sepsis in intensive care unit (ICU) of the hospital were selected from June 2023 to February 2024, and were randomized into control group (n=30) and observation group (n=30). The timely urine volume was monitored by the indwelling urodynamic device in the observation group, and the urine volume was recorded by the conventional letter urine bag in the control group. The levels of serum creatinine (Scr), blood urea nitrogen (BUN) and serum cystatin C (CysC) after 6, 12 and 24 hours of fluid resuscitation, blood lactate (LaC) and central venous oxygen saturation (ScvO2) after 6, 12 and 24 hours of fluid resuscitation, central venous pressure (CVP) and mean arterial pressure (MAP) after 12, 24 and 48 hours of fluid resuscitation and ICU stay were compared. Results There were statistical differences in Scr, BUN, CysC, LaC, ScvO2, CVP and MAP from the aspects of between-group, time-point and interaction (P<0.05). The longer the fluid resuscitation time was, the lower the levels of Scr, BUN, CysC and LaC were, and the above levels in the observation group were lower (P<0.05), and the higher the levels of ScvO2, CVP and MAP were, and the observation group had higher scores (P<0.05). The ICU stay in the observation group was lower in comparison with the control group (P<0.05). Conclusion Urodynamic device guidance of fluid resuscitation in patients with sepsis can improve the renal injury biomarkers, blood circulation status and tissue perfusion status, shorten the ICU stay. |
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