连续性肾脏替代在治疗严重脓毒血症中效果评价.docVIP

连续性肾脏替代在治疗严重脓毒血症中效果评价 　　[摘要]目的 通过观察严重脓毒血症患者连续性肾脏替代治疗的临床效果，分析连续性肾脏替代治疗严重脓毒血症的可行性。方法 选取2015年3月～2016年3月在我院接受连续性肾脏替代治疗的严重脓毒血症患者13例作为观察组，选取同期未进行连续性肾脏替代治疗而接受常规治疗的严重脓毒血症的患者13例作为对照组，记录两组患者治疗前后的临床数据包括乳酸、降钙素原、尿量等的变化情况，比较两组患者的治疗效果和病死率情况。结果 对比观察组和对照组患者的疾病严重程度（APCHEⅡ评分）和器官衰竭水平（SOFA评分），两者的差异无统计学意义（P0.05）；对比两组患者短期内乳酸、降钙素原的下降及尿量恢复情况，观察组均明显优于对照组，差异有统计学意义（P0.05）；急性期（7 d）病死率为7.69%，与对照组（38.46%）相比较显著降低，两者差异有统计学意义（P0.05）。结论 连续性肾脏替代治疗可提高严重脓毒血症患者急性期抢救成功率，具有一定的可行性，可以在临床上推广应用。 　　[关键词]连续性肾脏替代治疗；严重脓毒血症；急性肾功能损伤 　　[中图分类号] R459 [文献标识码] A [文章编号] 1674-4721（2017）05（b）-0037-03 　　Feasibility analysis of continuous renal replacement therapy for severe sepsis 　　OU Yuan WANG Ling 　　ICU，Heavy Steel General Hospital，Chongqing 400080，China 　　[Abstract]Objective By observing the clinical effect of continuous renal replacement therapy in patients with severe sepsis to analysis the feasibility of continuous renal replacement for severe sepsis.Methods 13 patients with severe sepsis who received continuous renal replacement therapy in our hospital from March 2015 to March 2016 were selected as observation group，13 patients with severe sepsis who had undergone continuous renal replacement therapy without conventional therapy were selected as the control group，the clinical data of the two groups were recorded before and after treatment，including lactic acid， procalcitonin，oxygenation index， urine output and so on，to compare the treatment and mortality of two groups.Results There was a significant difference between the two groups in the severity of disease （APCHE Ⅱ score） and organ failure （SOFA score），the difference was not statistically significant （P0.05）；Comparison of the two groups of patients in the short term lactate， procalcitonin decreased， increased oxygenation index and urine recovery，the observation group was significantly better，their difference was statistically significant （P0.05）；The mortality rate in the acute phase （7 days） was 7.69%，and significantly decreased compared with the control g