摘要
目的探讨医院获得性急性肾功能衰竭(HA-ARF)的病因及影响预后的相关因素。方法将住院急性肾功能衰竭(ARF)患者按发生地点分为HA-ARF与社区获得性ARF(CA-ARF),对比分析两组患者病因及预后。结果共收集ARF患者435例,占同期住院患者的0.27%,逐年比较呈增高趋势,其中HA-ARF 82例,CA-ARF 353例。HA-ARF组患者发病年龄47.8±22.9岁,>65岁老年患者比例为28.0%,大于CA-ARF组(P<0.01);HA-ARF组患者住院时间27.0±31.1d,较CA-ARF组长(P=0.013)。HA-ARF组患者主要病因是:与药物相关45例(54.9%),肾脏低灌注13例(15.8%),感染有关11例(13.4%),手术后10例(12.2%);肾前性ARF 13例(15.8%),肾性ARF 66例(80.5%),肾后性ARF 3例(3.7%)。HA-ARF患者死亡率高于CA-ARF患者(P<0.01)。HA-ARF组中老龄、无尿/少尿、严重的基础疾病、并发多器官功能衰竭患者死亡率高。结论药物、肾脏低灌注、感染、手术是引起HA-ARF的主要原因,老龄、无尿/少尿、严重的基础疾病、并发多器官功能衰竭是影响HA-ARF患者预后的重要危险因素。
Objective To investigate the pathogenesis and prognosis of hospital - acquired acute renal failure（HA- ARF）. Methods Patients with ARF in our hospital during the past 5 years were divided into HA - ARF group and community - acquired ARF（ CA - ARF） group according to ARF occurred in hospital or cocmmunity. The changes in pathogenesis and prognosis of two groups were studied. Results 435 cases from January 2000 to March 2005 were diagnosed as ARF during the 5 years accounting for 0.27% of the patients with an increasing trend, including 82 HA- ARF patients and the 353 CA - ARF patients. The mean age was （47.8 ± 22.9） years old, the patients over 65 years old accounted for 28.0% （23/82）, which was higher in HA - ARF than that in CA - ARF （ P 〉 0.01 ）. The average hospital stay （27.0 ± 3 1. 1 ） d was longer than （ 21.1 ± 15.3 ） d in CA - ARF group （ P = 0.013 ）. Drugs （ 45, 54.9% ）, low renal perfusion （ 13, 15.8 % ）, infections（ 11,13.4% ） and operations （ 10, 12.2 % ） were the major causes related to the development of HA - ARF; 13 cases （ 15.8% ） were pre - renal, 66 cases（ 80.5 % ） were intrinsic and 3 cases were post - renal factors. Compared with CA - ARF, mortality rate was higher in HA- ARF（ P 〈 0.01）.The mortality rate was higer in HA - ARF patients with elder age, anuria or oliguria, severe primary disease and multiple organ failure. Conclusion The major causes of hospital - acquired ARF were drugs, low renal peffusion, infections and operations; eider age, anuria or oliguria,severe primary disease and multiple organ failure were the important risk factors of death in HA - ARF.
出处
《中国急救医学》
CAS
CSCD
北大核心
2006年第1期18-21,共4页
Chinese Journal of Critical Care Medicine
关键词
急性肾功能衰竭
医院获得性
病因
预后
Acute renal failure（ARF）
Hospital - acquired
Pathogenesis
Prognosis
