血浆D-二聚体的检测对于加重期肺心病患者临床 - 内科急危重症杂志.DOC

连续性肾脏替代治疗(CRRT)在脓毒血症急性肾损伤治疗中的作用和透析时机探讨 江苏省泗阳县人民医院重症医学科 唐小宇 223700 【摘要】目的：研究连续性肾脏替代治疗(CRRT)在脓毒血症急性肾损伤（AKI）治疗中的作用和最佳透析时机。方法：从2012年6月-2014年12月我科诊治为脓毒血症AKI患者中随机选取92例作为研究对象。随机分组法分为观察组（46）例，对照组（46）例。对对照组实施普通药物治疗，观察组在此基础上实施CRRT治疗。按是否在48小时内启动CRRT，观察组分为两组，观察组（1）在常规药物治疗后（1.4±0.4）d进行CRRT治疗，观察组（2）于（3.1±0.3）d后进行CRRT治疗。观察并对比各组治疗疗效。结果：常规药物治疗后越早实施CRRT治疗，患者存活率越高。观察组治疗后APACHEⅡ评分显著改善，且改善程度高于对照组。观察组治疗后血肌酐水平、IL-1β含量显著降低，少尿现象显著改善，且改善程度显著高于对照组。差异均有统计学意义（均P＜0.05）。结论：CRRT治疗脓毒血症AKI，可显著改善患者炎症反应，调节内环境稳定。患者早期实施CRRT治疗，存活率更高。 【关键词】CRRT；脓毒血症;急性肾损伤；透析时机 Continuous renal replacement therapy (CRRT) role in the treatment of acute kidney injury in sepsis and dialysis time 【 bstract 】 bjective: To study the continuous renal replacement therapy (CRRT) in sepsis had a role in the treatment of acute kidney injury (AKI) and the optimal timing of dialysis. Methods: From June 2012 - December 2014 I branch of diagnosis and treatment for the patients with septic AKI in 92 cases were randomly selected as the research object. Random grouping method was divided into observation group (n = 46), the control group (n = 46). The control group was given with common drugs treatment, observation group on the basis of the implementation of CRRT treatment. According to start CRRT if smaller than 48 hour,And observation group average was divided into two groups, the observation group (1) after the routine drug treatment (1.4 ± 0.4) d for CRRT treatment, observation group (2) was?performed after the (3.1 ± 0.3) d CRRT treatment, observed two groups of curative effect. Results: The results showed that the routine drug treatment after the early implementation of CRRT treatment, patients survival rate was higher. Observation group after treatment with APACHE Ⅱ score improved significantly, and improved the level higher than the control group. Observation group after treatment serum creatinine levels, IL - 1 beta content decreased significantly, oliguria phenomenon was improved significantly, and the improvement was significantl