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目的观察持续静脉-静脉血液滤过(continuous venous-venous hemofiltration,CVVH)治疗剂量对危重患儿预后的影响。方法回顾性纳入2010年1月~2015年12月期间广东省人民医院接受CVVH治疗的危重患儿。比较CVVH处方低剂量组[≤35ml/(kg·h)]及高剂量组[>35ml/(kg·h)]间的预后。结果高剂量组和低剂量组30天住院死亡率(38.5%比46.2%,χ~2=0.265,P=0.607)、总住院时间[15(13,21)比17(9,24),Z=-0.239,P=0.811]及ICU内住院时间[13(6,21)比12(6,17),Z=-0.448,P=0.654]均无统计学差异。在Cox回归中对其他危险因素校正后,高剂量组仍未能减少住院死亡(HR0.768,95%CI,0.261~2.264,P=0.632)。结论超过35ml/(kg·h)的CVVH处方剂量未能改善危重患儿预后。
Objective To observe the effect of continuous venous-venous hemofiltration (CVVH) treatment on the prognosis of critically ill children. Methods Retrospectively included critically ill children undergoing CVVH treatment in Guangdong Provincial People’s Hospital from January 2010 to December 2015. The prognosis was compared between low-dose CVVH [≤35ml / (kg · h)] and high-dose [> 35ml / (kg · h)] groups. Results The 30-day in-hospital mortality rate (38.5% vs. 46.2%, χ ~ 2 = 0.265, P = 0.607), total length of hospital stay [15 (13,21) vs 17 = -0.239, P = 0.811] and hospital stay in ICU [13 (6,21) vs 12 (6,17), Z = -0.448, P = 0.654]. After adjustment for other risk factors in the Cox regression, the high-dose group did not reduce in-hospital mortality (HR 0.76, 95% CI, 0.261 to 2.264, P = 0.632). Conclusion Prescriptions of CVVH exceeding 35ml / (kg · h) failed to improve the prognosis of critically ill children.