不同时机连续性脏替代治疗(CRRT)对脓毒症患者的影响.pdfVIP

以上。而氧和指数（PaO2/FiO2）与尿量脓毒症 CRRT 组与脓毒症休克 CRRT 组相比， 无统计学差异（P＞0.05）。(2) CRRT组较对照组均具有统计学意义（P0.05），脓毒 症CRRT组治疗后第3天 APACHEⅡ评分较脓毒症休克CRRT组显著地降低(P＜0.05)， 且脓毒症CRRT组治疗后第3天便达到脓毒症休克CRRT组治疗后第7天的治疗效果， 但无统计学差异（P＞0.05）。而肾功能衰竭的病例数 CRRT 组明显低于对照组，且脓 毒症CRRT组低于脓毒症休克CRRT组；7d及28 d病死率低于晚期组，但未达到统计 学意义（P＞0.05）。 结论：在脓毒症早期及脓毒症休克期，CRRT 能够明显降低患者炎症指标，加速 患者血流动力学的稳定，能够更好的改善患者组织器官的灌注，且在脓毒症早期行 CRRT 治疗，较脓毒症休克期行 CRRT 治疗，APACHE II 评分降低更为明显，肾功能 衰竭患者数显著减少，降低患者 7d 及 28d 死亡率，改善患者的预后。支持脓毒症发 生后早期行 CRRT 治疗。 关键词 连续性肾脏替代治疗；脓毒症；APACHE II 评分；时机 Effect of Continuous Renal Replacement Therapy Started at Different Time on Patients with Sepsis Speciality: Surgery of traditional Chinese Medicine Author:Dong Yanzhen Tutor:Prof. Xie Jian Abstract Objective: Sepsis and sepsis shock is the leading cause of death in critically ill patients. The United States Centers for Disease Control ( CDC ) statistics, every year 751000 people suffering from sepsis, in which 215000 people died. In recent decades, despite aggressive supportive treatment and care, sepsis and sepsis shock mortality rate is still high. The overall hospital mortality in patients with sepsis in 28.6%, and severe sepsis and septic shock patients case fatality rates were 25% ~ 30% and 40% ~ 70%, global deaths per 1400 people, treatment of patients with huge cost, accounting for 40% ICU consumption. Now CRRT has been widely applied in ICU of patients with sepsis treatment, people has recognized for the timing of the onset is also affecting the mortality factors, But the begainning of time in patients with sepsis in the application of CRRT therapy is still not clear. The purpose of this study aims to sepsis and septic shock stage in patients with CRRT treatment comparison,