创伤后急性肾功能衰竭的临床分析

为探讨创伤后急性肾衰竭（ARF）病人的临床特点及早期肾替代治疗对预后的影响，回顾性分析71例创伤后ARF的临床特点，早晚期肾替代治疗效果，并与同期外科术后ARF病人进行了对比。结果发现，创伤后ARF占同期因创伤住院病人的1.06%，占同期ARF病人数的16.21%；ARF多元于伤后发生低血容量及横纹肌溶解症的病人，并发呼吸和神经系统功能衰竭时，更易发生ARF；其多脏器衰竭发生率为85.9%，，病死率高达70.4%；早期进行肾替代治疗可改善预后，其病死率（33.3%)明显低于晚期进行肾替代治疗者（59.2%)。说明创伤后ARF病人病情较重，预后差，肾替代治疗应早期进行。

CLINICAL CHARACTERISTICS OF PATIENTS WITH POST-TRAUMATIC ACUTE RENAL FAILURE

To investigate the clinical characteristics of patients with post traumatic acute renal failure (ARF)effect of early renal replacement therapy on their propnosis, a case control study was carried out in 71 cases of post traumatic ARF and 40 cases of post operative ARF. The effect of early renal replacement therapy on prognosis was evaluated. The incidence of post traumatic ARF in traumatic patients was 1 06%, and 16 21% in ARF. Rhabomyolysis and hypovolemia were the most common causes of ARF. Respiratory failure and coma were the predisposing factors of ARF. The incidence of multiple organ failure was 85 9% and the mortality was 70 4%. Early renal replacement therapy might improve the prognosis. The mortality of patients with Post traumatic ARF remains high, renal replacement therapy should be given as early as possible.