摘要
目的回顾性分析危重症患者急性肾脏损伤的影响因素。方法收集2012年8月至2017年6月重庆市九龙坡区第二人民医院及重庆市第七人民医院收治的120例伴急性肾脏损伤的危重症患者的临床资料,分析影响肾功能的危险因素。结果 120例患者中肾功能完全恢复50例(肾功能恢复组),部分恢复20例(肾功能部分恢复组),未恢复50例(肾功能未恢复组)。早期行连续性静脉-静脉血液滤过治疗是影响肾功能的主要因素。其中高血压、糖尿病、既往肾功能不全是影响肾功能的危险因素。肾功能恢复组、肾功能部分恢复组患者平均急性生理和慢性健康估测评分均明显低于肾功能未恢复组。原发病为低血容量患者中肾功能恢复比例较高,急性胰腺炎、心源性肾功能不全患者中肾功能未恢复比例较高。置换液剂量为35~45 mL/(kg·h)患者中肾功能恢复比例较高,置换液剂量小于35 mL/(kg·h)和大于45 mL/(kg·h)患者中肾功能未恢复比例较高。结论急性生理和慢性健康估测评分是影响肾功能恢复的重要因素,早期行连续性静脉-静脉血液滤过治疗可促进肾功能的恢复。
Objective To retrospectively analyze the factors of acute renal failure in patients with Methods The clinical data of critical patients with acute kidney injury in the Second People′s Hospital of Jiulongpo District of Chongqing and Chongqing 7th Hospital from August 2012 to June 2017 were collected to analyze the risk factors affecting renal function. Results Among the 120 patients,the renal function of 50 cases was completely recovered（complete recovery group）,20 cases was partially recovered（partial recovery group）and 50 cases was not recovered（un-recovery group）. The continuous veno venous hemofiltration treatment in early stage was the main factor. The hypertension,diabetes mellitus and renal inadequacy history were risk factors for renal function. The average APACHEⅡ score of patients in complete recovery group and partial recovery group was obviously lower than that in the unrecovery group. The proportion of renal function recovery in the patients with low blood volume was higher,while the proportion of un-recovery renal function is high in patients with acute pancreatitis or cardiogenic renal insufficiency. The proportion of replacement was higher in 35-45 mL/（kg·h）renal function recovery,while the proportion of renal failure is high in replacement volume less than 35 mL/（kg·h） and more than 45 mL/（kg·h）. Conclusion APACHEⅡ score is the important factors to he renal function recovery,and continuous veno venous hemofiltration treatment in
early stage can improve the recover of the renal function.
作者
张彬
朱朝江
杨洪梅
ZHANG Bin;ZHU Chaojiang;YANG Hongmei(The Second Medical Department,Second People′ s Hospital in Jiulongpo District,Chongqing 400052,China;Department of Endocrine Nephrology,Chongqing Seventh People ′s Hospital,Chongqing 400054,China)
出处
《现代医药卫生》
2018年第19期2959-2961,共3页
Journal of Modern Medicine & Health
基金
重庆卫生健康委员会科技项目(2012-2-460)
