评价连续性血液净化在重症医学中应用效果.docVIP

评价连续性血液净化在重症医学中应用效果 　　【摘要】 目的 评价连续性血液净化技术在重症医学中的应用效果。方法 回顾性分析83例接受连续性血液净化治疗患者的临床资料， 记录患者治疗后的情况。结果 83例患者中， 33例痊愈， 31例好转， 19例死亡， 死亡率为22.89%。19例死亡患者中， 2例为恶性血液疾病患者， 4例为脓毒症并多脏器衰竭患者（包括肾衰竭）， 8例为重度心力衰竭伴肾衰竭患者， 5例为肾衰竭患者。47例未死亡肾衰竭患者治疗前后血肌酐值、血尿素氮比较， 差异具有统计学意义（P0.05）。10例未死亡脓毒症患者治疗后体温为（36.63±0.60）℃， 明显低于治疗前的（38.20±0.91）℃， 差异具有统计学意义（P0.05）。死亡患者急性生理学与慢性健康状况评分（APACHEII评分）为（29.74±2.57）分， 明显高于未死亡患者的（22.09±2.47）分， 且死亡患者ICU住院时间为（13.31±8.18）d， 明显多于未死亡患者的（9.89±5.50）d， 差异均具有统计学意义（P0.05）。结论 连续性血液净化技术在重症医学中的广泛应用， 可有效救治重症患者。 　　【关键词】 连续性血液净化；技术；重症医学 　　DOI：10.14163/j.cnki.11-5547/r.2016.35.039 　　【Abstract】 Objective To evaluate application effect by continuous blood purification in critical care medicine. Methods A retrospective analysis was made on clinical data of 83 patients receiving continuous blood purification for treatment， and records were made on their status after treatment. Results Among the 83 patients， there were 33 healed cases， 31 improved cases， and 19 death cases， with mortality rate as 22.89%. Among the 19 death cases， there were 2 cases with malignant hematologic diseases， 4 cases with sepsis and complicated multiple organ failure （including renal failure）， 8 cases with severe heart failure and renal failure， and 5 cases with renal failure. The difference of serum creatinine and blood urea nitrogen before and after treatment had statistical significance in 47 survived cases with renal failure （P0.05）. Body temperature after treatment was （36.63±0.60）℃ in 10 survived cases with sepsis， and it was obviously lower than （38.20±0.91）℃ before treatment， and the difference had statistical significance （P0.05）. Death cases had much higher acute physiology and chronic health evaluation Ⅱ （APACHEⅡ） score as （29.74±2.57） points than （22.09±2.47） points in survived cases. Death cases also had much longer ICU stay time as （13.31±8.18） d than （9.89±5.50） d in survived cases. Their differences all had statistical significance （P0.05）. Conclusion Wide application of continuous blood pu