急诊危重病监护室患者并发急性肾损伤的临床及预后影响因素分析

目的 分析急诊危重病监护室患者并发急性肾损伤（acute kidney injury,AKI）的病因、临床特点及预后影响相关因素.方法 对急诊危重监护室治疗的2215例患者的临床资料进行回顾性分析,将并发AKI的67例患者作为观察组,同时期无肾损伤的67例患者作为对照组,对导致AKI的原因、临床特点以及芪参活血颗粒对预后影响因素进行对比分析.结果 感染、血压控制不佳、应用肾毒性药物因素是导致AKI发生的重要病因;观察组中Al组总有效率（75.8%）显著优于A2组（38.2%）,两组比较差异有统计学意义（P〈0.05）;非老年组总有效率（ 67.7%）明显高于老年组（47.2%）,两组比较差异有统计学意义（P〈0.05）;老年组8例死亡,非老年组3例死亡.Logistic回归分析可知,呼吸衰竭、少尿、消化道出血、尿素氮、肾脏替代治疗为影响AKI预后的主要因素.结论 急诊危重病监护室患者应针对病因进行及早预防,同时配合中成药来改善患者临床症状和肾功能,降低致死率.

The etiology,clinical features and effective prognostic factors analysis of patients with acute kidney injury

Objective To analyze etiology,clinic.al features and prognostic factors analysis of intensive care unit （ICU） patients with acute kidney injury.Methods The clinical data of 2215 cases in ICU of our hospital were retrospectively analyzed,67 patients complicated with acute kidney injury were considered as the observation group,and at the same period 67 patients without kidney injury were considered as the control group,and analyzed their acute kidney injury causes.clinical features and Qishen Huoxue Keli prognostic affecting factors.Results Infections,poor blood pressure control.the application of nephrotoxic drugs factors leading to an important cause of AKI occurred; the total efficiency of the patients in non-aged group was 67.7%.significantly higher than 47.2% of the elderly group （P 〈 0.05）; the elderly group,8 cases of ineffective patients eventually died.the cause of death was associated with diabetes.severe infections and heart vascular disease; non-elderly group had 3 ineffective cases due to infection and death in patients with primary heart disease; logistic regression analysis showed that respiratory failure,oliguria,gastrointestinal bleeding,blood urea nitrogen,renal replacement therapy.and the factors of OR values were 8.403,7.432,6.137,5.349 and 5.516 respectively,with statistical significant difference （P 〈 0.05）.which were the main factors affecting prognosis of AKI.Conclusion Emergency critically disease ICU patients should be according to the cause for early prevention,and combine with Chinese patent medicine to improve clinical symptoms and renal function,and reduce the mortality rate.