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Objective:To investigate the effect of the timing of continuous renal replacement therapy (CRRT) administration on the prognosis of acute kidney injury (AKI) in children.Methods:The medical records of children with AKI who were admitted to the Intensive Care Unit of Hunan Children′s Hospital from March 2015 to February 2020 and underwent CRRT were prospectively analyzed.The children who met the criteria were divided into early group (defined as AKI 1 and 2) and delayed group (defined as AKI 3) according to AKI stage.The general conditions, indicators when CRRT was initiated, and prognosis of the children in two groups were recorded.Results:(1) A total of 39 children were included in the study, including 23 in the early group and 16 in the delayed group.There were no significant differences in age, gender, body weight and proportion of mechanical ventilation between two groups ( P>0.05). The score of critical cases in the early group was higher than that in the delayed group ( P=0.008). (2) There were no significant differences in serum potassium and bicarbonate when CRRT was initiated between two groups ( P>0.05). The urine output in the early group was higher than that in the delayed group ( P>0.001). The serum creatinine and urea nitrogen in the early group were lower than those in the delayed group ( P>0.05). (3) The 28-day survival rate and proportion of renal function recovery at 28 days in the early group were significantly higher than those in the delayed group ( P>0.05). The duration of CRRT, ICU stay and duration of mechanical ventilation in the early group were shorter than those in the delayed group ( P>0.05). Conclusion:Early initiation of CRRT at AKI stage 1 and 2 can improve the 28-day survival rate and renal function recovery of survivors when critically ill children are complicated with AKI.
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OBJECTIVE:To investigate the effects of application timing of carboporst tromethamine on postpartum hemor-rhage and hemodynamics of cesarean section women with centralplacenta previa. METHODS:Totally 138 parturient women with central placenta previa selected from our hospital during Jan.-Dec. 2015 were divided into observation group and control group ac-cording to random number table,with 69 cases in each group. Both groups received cesarean section. Control group was given Car-boporst tromethamine injection 250 μg on uterine body after the delivery of placenta. Observation group was given Carboporst tro-methamine injection 250 μg on corpora uteri immediately after umbilical cord cutting. The operation duration,intraoperative and postoperative blood loss were observed in 2 groups. The preoperative and postoperative 24 h hemodynamic index,coagulation func-tion and corpora uteri were compared between 2 groups. RESULTS:The operation duration of observation group was significantly shorter than control group;intraoperative blood loss and 24h blood loss of observation group were significantly less than control group,with statistical significance(P0.05). 24 h after surgery,SBP,DBP,MAP,FIB and D-D of 2 groups were decreased significantly,while HR of them were increased significantly;the observation group was significantly better than the control group,with statistical significance (P0.05). CONCLUSIONS:Carboporst tromethamine after omphalotomy via uterine body helps to shorten the operation time,reduce intraoperative blood loss,maintain hemodynamic indexes stable and improve coagulation func-tion of cesarean section women with central placenta previa ,with good safety.