内科病因急性肾功能衰竭合并多系统脏器衰竭

本文分析103例内科病因急性肾功能衰竭(ARF)的临床资料。结果表明,74％患者合并多系统脏器衰竭(MSOF)。MSOF的病死率高达41％;衰竭的脏器越多,病死率越高。然而,透析组的病死率和MSOF发生率均显著低于非透析组。作者认为,ARF诊断不及时和透析时机、方式选择不当是引起MSOF的原因之一。因此,早期诊断和早期预防性、充分透析对MSOF的防治是至关重要的。在透析疗法配合下,重视胃肠外营养疗法可望改善内科病因ARF的预后。此外,严重感染是导致MSOF的主要因素,应予积极防治。

MEDICAL ACUTE RENAL FAILURE WITH CONCOMITANT MULTIPLE SYSTEM ORGAN FAILURE

Clinical data of 103 patients with acute renal failure (ARF) due to medical causes are analysed. Results showed that in 74% patients, there was concomitant multiple system organ failure (MSOF). The mortality of MSOF was as high as 41 % in this series. The greater the extent of systemic organ failure, the higher the mortality. However, the incidence and mortality of MSOF was significantly lower in the dialyzed group, than in the nondialyzed group. In our opinion, delayed diagnosis and treatment of ARF and inappropriate selection of the modality of hemopurification are contributing factors in the development of MSOF. It should be stressed that early diagnosis with prophylactic and adequate dialysis may improve the prognosis of ARF patients with MSOF. Attention should also be paid to adequate parenteral nutrition. Furthermore, it is imperative to prevent and treat aggressively severe infections which are the main factors associated with MSOF in medical patients.