不同时机连续性肾脏替代治疗CRRT对脓毒症患者的影响.doc

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, the observation of different timing of CRRT therapy for patients with sepsis inflammatory index, hemodynamics, tissue perfusion and prognostic implications, discussion on CRRT in patients with sepsis in the application of the best treatment time, for the more reasonable sepsis treatment to accumulate more experience, to provide basis for clinical therapy. Methods: A retrospective analysis of 2010 February to 2012 February Shandong provincial Qianfo Hill hospital integrated parallel CRRT ICU treated patients with sepsis in 81 cases, according to the patients with CRRT therapy severity of illness for sepsis in 21 cases in CRRT group, control group 19 cases of sepsis, septic shock, 22 cases in group CRRT, septic shock in 19 cases in the control group. All patients were