探讨脓毒症患者连续性肾脏替代治疗的时机选择及其预后影响因素.方法 将210例脓毒症患者根据急性生理学与慢性健康状况评分Ⅱ评分分为研究组112例,对照组98例,比较治疗前后两组生化及生理指标变化情况,评估影响患者预后的影响因素.结果 治疗后两组各项指标与治疗前比较差异均有统计学意义(P＜0 .05) ,研究组心率、平均动脉压、白细胞计数、血小板计数、血尿素氮、血肌酐较对照组变化更显著.休克、连续性肾脏替代治疗开始时间、急性生理学与慢性健康状况评分Ⅱ评分是影响患者预后的独立危险因素(P＜0 .05).结论 连续性肾脏替代治疗可有效改善脓毒症患者的生化及生理指标,休克、连续性肾脏替代治疗开始时间、急性生理学与慢性健康状况评分Ⅱ评分是影响脓毒症患者预后的独立危险因素.、Objective To analyze the timing and prognostic factors of continuous renal replacement thera-py in patients with sepsis.Methods 210 patients with sepsis were divided into study group (112 cases) and control group (98 cases) according to acute physiology and APACHE Ⅱ.The changes of biochemical and physiological indexes in the two groups before and after treatment were compared ,and the factors in-fluencing the prognosis of the patients were evaluated.Results After treatment ,the difference between the two groups was statistically significant (P＜0.05).Heart rate ,mean arterial pressure ,white blood cell count ,platelet count ,blood urea nitrogen and serum creatinine in the study group changed more sig-nificantly than those in the control group.Shock ,onset time of continuous renal replacement therapy ,a-cute physiology and APACHE Ⅱ were independent risk factors for prognosis (P＜0.05).Conclusion CRRT can effectively improve the biochemical and physiological indexes of patients with sepsis.Shock , onset time of continuous renal replacement therapy ,acute physiology and APACHE Ⅱ are independent risk factors on prognosis in patients with sepsis.