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目的:研究分析肾脏替代治疗时间的选择对重症急性肾功能衰竭患者预后的影响.方法:根据急性肾损伤标准将来我院就诊的50例急性肾功能衰竭患者分为Ⅰ期(18例),Ⅱ期(15例),Ⅲ期(17例),均给予肾脏替代治疗,并比较治疗前和治疗后各项指标的差异以及病死率.结果:Ⅰ期病死率为33.33%(6/18)例,Ⅱ期病死率为60.0%(9/15),Ⅲ期病死率为82.35%(14/17),Ⅱ期和Ⅲ期病死率明显高于Ⅰ期病死率(P<0.05).肾脏替代治疗后三组患者的血钾、血尿素氮、血肌酐值以及APACHEⅡ评分等都具有明显的下降,Ⅰ期急性肾功能衰竭患者的血乳酸值明显降低,氧合指数具有明显的升高,但Ⅱ期,Ⅲ期没有明显变化.结论:对重症急性肾功能衰竭患者采用AKIN分期以及肾脏替代治疗对重症急性肾功能衰竭患者的早期诊断和预后具有重要的意义.“,”Objective: To study the choice of time of renal replacement therapy in patients with severe acute renal failure prognosis. Methods: according to the standards of the future of acute kidney injury in our hospital, 50 cases of acute renal failure patientsⅠ(18 cases),Ⅱ(15 cases),Ⅲ(17 cases), were given the renal replacement therapy, and compared before and after the treatment of each index difference and fatality rate. Results : in the first phase the fatality rate was 33.33% (6/18) cases, phase I mortality rate was 60% (9/15), stage Ⅲmortality rate was 82.35% (14/17),Ⅱ and Ⅲmortality was significantly higher in stage Ⅰfatality rate (P < 0.05). Renal replacement therapy after three groups of patients Serum potassium, serum urea nitrogen, SCr and APACHE Ⅱare obvious decline stage of patients with acute renal failure, blood lactic acid value decreased, oxygenation index has significantly increased, but the stage Ⅱ,Ⅲ stage did not significantly change. Conclusion: in patients with severe acute renal failure with AKIN staging and renal replacement therapy for severe acute renal failure in patients with early diagnosis and prognosis has important significance.