重度热烧伤并发急性肾衰竭临床分析

目的寻找有助于早期诊断热烧伤并发急性肾衰竭(ARF)的诊断指标以及指导治疗和预防的有用措施.方法回顾性分析117例重度热烧伤病人的临床资料,并对其中合并急性肾衰竭的29例患者的可能因素进行相关分析.结果占24.8%的重度热烧伤患者并发ARF,而合并ARF的烧伤患者死亡率显著高于普通组(P＜0.001);ARF组烧伤面积显著高于普通组,而入院时血清白蛋白水平明显低于普通组(P＜0.001);合并ARF热烧伤患者肌酐(Scr)水平峰值与烧伤面积呈正相关,与入院时血清白蛋白水平呈负相关.结论血清白蛋白的丢失和消耗在重度热烧伤并发ARF中起极其重要的作用,及早纠正低蛋白血症对预防重度热烧伤并发ARF具有重要意义,低蛋白血症可作为早期诊断热烧伤并发ARF的参考指标之一.

Clinical analysis of acute renal failure in severely thermal burn

Objective:To explore some early useful diagnosis parameters and some methods to prevent and treat acute renal failure in severely thermal burn,a serious complication of the disease.Methods:Chlinical data of 119 patients with severely thermal burn (second-and third-degree burns covering 30% or more of their body surface area) was analyzed retrospectively.The related factors of ARF in the total of 29 patients complicated with ARF were also analyzed retrospectively.Results:24.8% patients with severely thermal burn complicated with ARF.Mortality rate in ARF group higher than that in ordinary group significantly (P<0.001).Burned body area in ARF group higher than that in ordinary group significantly (P<0.001) but sera albumin levels in ARF group lower than that in ordinary group significantly (P<0.001).Sera creatinine (Scr) in ARF group correlated positively with burned body area and negatively with sera albumin levels.Conclusion:The losing and the Consumption of albumin play an important role in severely thermal burn complicated with ARF.Redress hypoalbuminemia at an early date may be a good method to prevent ARF complicated form severely thermal burned.Hypoalbuminemia maybe act as a useful parameter to diagnose ARF in severely thermal burned