Comparative analysis of the impact of different CRRT intervention treatment times on coagulation function in patients with severe sepsis
对比分析不同CRRT介入治疗时间对重度脓毒症患者凝血功能的影响

摘要

目的 探究不同连续性肾脏替代治疗（CRRT）介入治疗时间对重度脓毒症患者凝血功能的影响。方法 在本院2024年7月-2025年9月收治的重度脓毒症患者中选取符合研究条件的78例，采用随机对照方法，将患者分为对照组（n=26）、早期组（n=26）和晚期组（n=26）。对照组采用常规治疗方法，早期组及晚期组则需要基于对照组配合连续性血液净化对患者做好治疗方案安排，根据患者疾病发展进程进行分组，并开展三组对比工作，分析临床效果差异。结果 三组患者在治疗前凝血四项指标均无明显差异，经过治疗干预后，采用CRRT介入治疗的早期组和晚期组Fib指标数据均高于对照组，相比之下晚期的Fib指标数据更高。对照组的凝血酶时间（TT）、活化部分凝血活酶时间（APTT）、凝血酶原时间（PT）三项指标的数据均高于早期组和晚期组，在早期组和晚期组的内部对比中，早期组上述三项指标数据更低，P＜0.05。三组患者2周病死率差异显著，在三组对比中对照组患者病死率更高，病死患者更多（Z=6.563，P＜0.05）；早期组患者的病死率远低于对照组（χ2=5.386，P＜0.05）。三组患者治疗前的急性生理学与慢性健康状况评分Ⅱ（APACHE Ⅱ）评分无明显差异，从总体上来看，治疗后早期组和晚期组的评分均低于对照组，单纯对比早期组与晚期组，早期组的评分更低，P＜0.05。结论 在对重度脓毒症患者实施治疗的过程中，通过调整CRRT介入治疗时间能够对临床治疗效果产生一定影响，在早期开展治疗可以显著改善患者凝血功能，进一步降低患者的死亡概率，有利于促进患者身体状态恢复。

Abstract

Objective To explore the impact of different Continuous Renal Replacement Therapy (CRRT) intervention treatment times on the coagulation function of patients with severe sepsis.
Methods Among the 78 patients with severe sepsis admitted to our hospital from July 2024 to September 2025 who met the research conditions, a random control method was adopted to divide the patients into the control group (n=26), the early group (n=26), and the late group (n=26). The control group received conventional treatment, while the early group and the late group needed to cooperate with continuous blood purification based on the control group to make treatment plans for the patients, and the patients were grouped according to the disease development process and the comparison was carried out among the three groups to analyze the differences in clinical effects.
Results Before treatment, there were no significant differences in the four coagulation indicators of the three groups. After treatment intervention, the Fib indicators of the early group and the late group treated with CRRT were higher than those of the control group, and the Fib indicator data of the late group was higher than that of the early and late groups. The Thrombin Time (TT), Activated Partial Thromboplastin Time (APTT), and Prothrombin Time (PT) indicators of the control group were higher than those of the early and late groups. In the internal comparison of the three groups, the above three indicators of the early group were lower than those of the early and late groups, and P < 0.05. There was a significant difference in the 2-week mortality rate among the three groups. In the comparison of the three groups, the mortality rate of the control group was higher, and there were more deaths (Z = 6.563, P < 0.05); the mortality rate of the early group was much lower than that of the control group (χ2 = 5.386, P < 0.05). There was no significant difference in the Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE II) score of the three groups before treatment. Overall, the scores of the early group and the late group were lower than those of the control group, and a simple comparison between the early group and the late group showed that the score of the early group was lower, P < 0.05.
Conclusion   During the treatment of patients with severe sepsis, adjusting the CRRT intervention treatment time can have a certain impact on the clinical treatment effect. Early treatment can significantly improve the coagulation function of patients and further reduce the mortality rate, which is conducive to promoting the recovery of the patient's physical condition.