The Effect Of Hybrid Renal Replacement Therapy On The Survival Time Of Patients With Sepsis

Object:1.Whether hybrid renal replacement therapy can reduce the level of serum inflammatory factors in patients with sepsis.2.Whether hybrid renal replacement therapy can reduce the score of Acute Physiology and Chronic Health Evaluation II and Sequential organ failure aossessment in sepsis patients.3.Study of hybrid renal replacement therapy can reduce the patients with sepsis 90 day all-cause mortality.Methods: Methods from October 2015 to September 2017,108 patients with sepsis were selected as the research subjects.According to the different treatment regimens,they were randomly divided into control group and experimental group according to 1:1,54 cases in each group.The control group was treated with routine treatment,and the experimental group was combined with hybrid renal replacement therapy on the basis of routine treatment.Observation of 48 h in the treatment of the two groups before and after 24 h treatment,plasma inflammatory cytokines TNF-α,IL-1,IL-6,IL-8to evaluate the acute physiology and chronic health before and after treatment in two groups(acute physiology and chronic health evaluation,APACHEII score)and sequential organ failure score(sequential organ failure assessment,SOFA score),compared two groups of patients with ICU hospitalization days and total hospitalization time,hospitalization costs,the number of hours of mechanical ventilation and use of antibiotics were DDD value.The patient’s survival days and death were recorded.Results: Group in peripheral blood of patients with TNFα-,IL-1,IL-6,IL-8and the same level after treatment of common group decreased significantly,the differences were statistically significant(P< 0.05).After treatment,the scores of APACHE II and SOFA in the experimental group were significantly lower than those in the normal group,and the difference was statistically significant(APACHEII score,P=0.001,SOFA score,P=0.043).The number of hours of mechanical ventilation in the test group(70.31±107.00)was compared with the control group(113.35±103.25)(P=0.035).The DDD value of the test group was(15.62±9.09)and that of the control group(19.91±9.95)(P=0.039).Length of stay ICU of the experimental group(9.39±4.52)and control group(11.33±4.66)(P=0.030),the experimental group total hospital stay(18.24±17.17)was significantly shorter than the control group(24.63±15.10)(P=0.043),hospitalization expense was slightly higher than the control group,but not statistically significant(P= 0.670).There was no significant difference in mortality between the two groups in 28 days and 60 days after treatment(P > 0.05).The mortality of the 90 days in the experimental group(33%)was lower than that in the control group(56%)(P=0.034).Conclusion:1.hybrid renal replacement therapy can rapidly remove inflammatory cytokines,reduce sepsis patients serum levels of inflammatory factors;2.heterozygous renal replace therapy can improve the condition of patients with sepsis,decrease SOFA,APACHEII score,reduce the time of mechanical ventilation,the use of antibacterial drugs DDD,ICU and shorten the hospitalization days and total hospitalization days and not obvious increase thencost of hospitalization;3.hybrid renal replacement therapy did not significantly reduce sepsis in 28 days,60 day mortality,but can reduce the patients with sepsis 90 days mortality.