目的 探究连续性血液净化（CBP）联合亚胺培南西司他丁钠对脓毒症休克合并急性肾损伤（AKI）患者的疗效。 方法 选取2022年1月到2024年6月医院接收的80例脓毒症休克合并AKI患者，按治疗方法分为CBP组（n = 37）和联合组（n = 43）。CBP组给予CBP治疗，联合组给予CBP联合亚胺培南西司他丁钠治疗。比较两组的脏器功能、血流动力学、炎症因子、预后指标及生存情况。 结果 治疗后，联合组的动脉血氧分压/吸入氧浓度（PaO?/FiO?）、血小板计数（PLT）、平均动脉压（MAP）高于CBP组，血清肌酐（SCr）、去甲肾上腺素（NE）用量、心率（HR）、乳酸（Lac）、序贯性器官功能衰竭（SOFA）评分、急性生理学与慢性健康状况评分 Ⅱ（APACHE Ⅱ）评分低于CBP组（P < 0.05）；联合组的白细胞计数（WBC）、C反应蛋白（CRP）、降钙素原（PCT）、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、白细胞介素-10（IL-10）低于CBP组（P < 0.05）。联合组的ICU住院时间低于CBP组，28 d肾功能恢复率高于CBP组（P < 0.05）；两组的7 d、28 d病死率比较，差异无统计学意义（P > 0.05）。Log-rank比较CBP组与联合组的28 d累积生存率，差异无统计学意义（P > 0.05）。 结论 CBP联合亚胺培南西司他丁钠治疗脓毒症休克合并AKI患者，可改善炎症反应、稳定血流动力学、促进肾功能恢复及缩短ICU住院时间。

Objective To investigate the efficacy of continuous blood purification （CBP） combined with imipenem/cilastatin in patients with septic shock complicated by acute kidney injury （AKI）. Methods A total of 80 patients with septic shock and AKI admitted to our hospital from January 2022 to June 2024 were enrolled. According to treatment methods， they were divided into the CBP group （n = 37）， receiving CBP therapy， and the combination group （n = 43）， receiving CBP plus imipenem/cilastatin therapy. Organ function， hemodynamics， inflammatory markers， prognostic indicators， and survival outcomes were compared between the two groups. Results After treatment， arterial oxygen partial pressure/fraction of inspired oxygen （PaO?/FiO?）， platelet count （PLT）， and mean arterial pressure （MAP） were higher in the combination group than in the CBP group， while serum creatinine （SCr）， norepinephrine （NE） dosage， heart rate （HR）， lactate （Lac）， Sequential Organ Failure Assessment （SOFA） score， and Acute Physiology and Chronic Health Evaluation Ⅱ （APACHE Ⅱ） score were lower （P < 0.05）. White blood cell count （WBC）， C-reactive protein （CRP）， procalcitonin （PCT）， tumor necrosis factor-α （TNF-α）， interleukin-6 （IL-6）， and interleukin-10 （IL-10） were also significantly lower in the combination group （P < 0.05）. The combined treatment group had a shorter ICU length of stay compared to the CBP group， and a higher 28-day renal function recovery rate （P < 0.05）.However， no statistically significant differences were found in the 7-day or 28-day mortality rates between the two groups （P > 0.05）. Log-rank analysis revealed no significant difference in the 28-day cumulative survival rate between the groups （P > 0.05）. Conclusion The combination of CBP and imipenem/cilastatin for septic shock patients with AKI can improve inflammatory response， stabilize hemodynamics， promote renal recovery， and reduce ICU stay.