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

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1、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(AKT)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患者小随机选取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，观察组在此慕础上实施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

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APACHETT评分显著改善，且改善程度高于对照组。观察组治疗后血肌酢水平、IL-1B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)o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Continuousrenalreplacementtherapy(CRRT)r

3、oleinthetreatmentofacutekidneyinjuryinsepsisanddialysistime【Abstract]Objective:Tostudythecontinuousrenalreplacementtherapy(CRRT)insepsishadaroleinthetreatmentofacutekidneyinjury(AKI)andtheoptimaltimingofdialysis.Methods:FromJune2012-December2014Ibranchofdiagnosisandtreatmentforthe

4、patientswithsepticAKIin92caseswererandomlyselectedastheresearchobject.Randomgroupingmethodwasdividedintoobservationgroup(n=46),thecontrolgroup(n=46).Thecontrolgroupwasgivenwithcommondrugstreatment,observationgrouponthebasisoftheimplementationofCRRTtreatment.AccordingtostartCRRTifs

5、mallerthan48hour,Andobservationgroupaveragewasdividedintotwogroups,theobservationgroup(1)aftertheroutinedrugtreatment(1.4±0.4)dforCRRTtreatment,observationgroup(2)wasperformedafterthe(3」土03)dCRRTtreatment,observedtwogroupsofcurativeeffect.Results:Theresultsshowedthattheroutinedrug

6、treatmentaftertheearlyimplementationofCRRTtreatment,patients*survivalratewashigher.ObservationgroupaftertreatmentwithAPACHEITscoreimprovedsignificantly,andimprovedthelevelhigherthanthecontrolgroup・Observationgroupaftertreatmentserumcreatininelevels,IL-1betacontentdecreasedsignific

7、antly,oliguriaphenomenonwasimprovedsignificanil%andtheimprovementwassignificantlyhigherthanthecontrolgroup,whichwerestatisticallysignificantdifferences（allP<0.05）.Conclusion:CRRTtreatmentsepticAKI,inflammation,cansignificantlyimprovepatientsadjustinternalenvironmentstable.Patients

8、withearlyimplementationofCRRTtrea