摘要
目的分析新生儿急性肾损伤(AKI)的临床特点,了解影响新生儿AKI预后的危险因素。方法回顾分析2012年1月至2019年3月符合AKI诊断标准且临床资料齐全的105例新生儿的相关临床资料。按照治疗结局将患儿分为好转组和放弃或死亡组,比较两组临床特点,分析影响新生儿AKI预后的危险因素。结果共纳入105例AKI患儿,好转组48例、放弃或死亡组57例。与好转组相比,放弃或死亡组患儿的出生体质量低,极低出生体质量儿比例高,最低尿量值低,尿量<1 mL/(kg·h)的比例高,休克、呼吸衰竭、凝血功能障碍、肺出血、消化道出血发生率高,使用呼吸机支持治疗的比例高,差异均有统计学意义(P<0.05)。多元logistic回归分析结果显示,尿量<1 mL/(kg·h)、合并呼吸衰竭是影响新生儿AKI预后的独立危险因素(OR=4.61,95%CI:1.68~12.63,P=0.003;OR=17.88,95%CI:5.61~56.98,P<0.001)。结论新生儿AKI的病死率高,少尿、合并呼吸衰竭显著增加AKI新生儿发生不良预后的风险。
Objective To explore the clinical characteristics of neonatal acute kidney injury(AKI)and the risk factors affecting the prognosis of AKI.Methods The clinical data of 105 neonates who met the diagnostic criteria for AKI and had complete clinical data from January 2012 to March 2019 were reviewed.According to the treatment outcome,the neonates were divided into the improved group and the abandonment/death group,and the clinical characteristics of the two groups were compared to analyze the risk factors affecting the prognosis of neonatal AKI.Results A total of 105 neonates with AKI were included,including 48 cases in the improvement group and 57 cases in the abandon/death group.Compared with the improvement group,the birth weight of the neonates in the abandon/death group was lower,the proportion of neonates with very low birth weight was higher,the minimum urine output value was lower,the ratio of urine output<1 mL/(kg·h)was higher,the incidences of shock,respiratory failure,coagulopathy,pulmonary hemorrhage and gastrointestinal hemorrhage were higher,and the proportion of using ventilator support treatment was higher.These differences were statistically significant(P<0.05).Multivariate logistic regression analysis showed that urine output<1 mL/(kg·h)and respiratory failure were independent risk factors affecting the prognosis of neonatal AKI(OR=4.61,95%CI:1.68~12.63,P=0.003;OR=17.88,95%CI:5.61~56.98,P<0.001).Conclusion The mortality of neonatal AKI is high.Oliguria and respiratory failure significantly increase the risk of poor prognosis in neonates with AKI.
作者
张婷
李晓文
ZHANG Ting;LI Xiaowen(Neonatal Diagnosis and Treatment Center,Children's Hospital of Chongqing Medical University,Chongqing Key Laboratory of Pediatrics,Ministry of Education Key Laboratory of Child Development and Disorders,National Clinical Research Center for Child Health and Disorders,China International Science and Technology Cooperation Base of Child Development and Critical Disorders,Chongqing 400014,China)
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2021年第9期646-649,655,共5页
Journal of Clinical Pediatrics
关键词
急性肾损伤
预后
危险因素
新生儿
acute kidney injury
prognosis
risk factor
neonate
