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重症监护中心急性肾功能衰竭的临床特点分析(1)
http://www.100md.com 2010年5月1日 陈锦华 刘海俊 谢敏妍 梁智敏
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     【摘要】 目的 分析我院重症监护中心(ICU)中急性肾功能衰竭(ARF)的临床特点。方法 回顾2005年10月30日至2008年5月30日在我院ICU中87例ARF患者的病例资料,分院内及社区两组,比较分析其发病年龄、病因、合并症以及转归等临床特点。结果 院内组及社区组均以肾前性ARF为主,比例分别为73.17%和56.52%;院内组肾性ARF基本为医源性的,社区组肾性ARF主要与本身疾病有关;ICU的ARF患者死亡率较高(58.62%),院内组死亡率为70.73%明显高于社区组(47.83%),然而社区组ARF合并多器官功能衰竭的比例(39.13%)却明显高于院内组(17.07%)。结论 ICU中ARF患者多为肾前性,常合并多器官功能衰竭,院前ARF患者尤应注意有无合并多器官功能衰竭;对有ARF危险因素的住院患者应积极预防医源性ARF。

    【关键词】急性肾功能衰竭;重症监护中心;多功能器官衰竭;医源性

    Study on clinical characteristic in ICU hospitalized patients with acute renal failure

    CHEN Jin hua,LIU Hai jun,XIE Min yuan,et al.Department of Nephrology,People’s Hospital of PanYu District,Guangzhou,511400,China

    【Abstract】 Objective To analyze the clinical characteristic of acute renal failure(ARF)in intensive care unit(ICU).Methods The medical records of 87 ARF patients who were received in ICU from October 30,2005 to May 30,2008 were reviewed and divided into two groups:hospital group and community group.Clinical characteristic of the two groups were compared and analyzed,including age,etiopathogenisis,complications,outcomes and so on.Results Hospital group and community group were mainly prerenal ARF,the ratio were 56.52%and 73.17%; intrinsic ARF of hospital group mostly were iatrogenic,while those of community group were caused by diseases themselves.Mortality of ARF patients in ICU was high(58.62%),but the rate of hospital group was 70.73%,which was significantly higher than community group(47.83%).However,the proportion of ARF with multiple organ failure in community group were 39.13%,which was significantly higher than the hospital group(17.07%).Conclusion ARF patients in ICU are mainly prerenal,often complicated by multiple organ failure,and pre hospital ARF patients should be kept one more eye on the complicated multiple organ failure.The in hospital patients with ARF risk fators should be taken an active prevention from iatrogenic ARF.

    【Key words】Acute renal failure;Intensive Care unit;Multiple organ failure;Iatrogenic

    急性肾功能衰竭(acute renal failure,ARF)能在短期内使患者的肾小球滤过率迅速下降,导致血肌酐和尿素氮水平增高,水、电解质和酸碱平衡失调,明显扰乱患者机体内环境,增加救治难度 ......

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