多器官功能障碍综合征中急性肾衰竭高病死率风险因素探讨

目的探讨多器官功能障碍综合征（MODS）中急性肾衰竭（ARF）的病死率、死亡危险因素及有效治疗措施。方法回顾性分析694例MODS患者，其中发生ARF者441例的临床资料。结果MODS中ARF者发生率为63．5％，病死率达59．7％。本研究的单因素分析显示，MODS中ARF组与非ARF组比较，年龄、呼吸次数、血钠、血糖、心输出量较高，血压、CVP、pH、BE、外周血管阻力值较低，血液净化技术、胃肠内营养两组间比较差异有显著性。经Logistic回归分析，年龄、血BUN、收缩压、CVP、氧合指数、动脉血二氧化碳分压是主要死亡危险因素，血液净化技术、胃肠内营养是保护性因素。结论MODS中ARF者病死率较高，胃肠内营养、血液净化技术能降低死亡率。

Clinical analysis of high mortality of acute renal failure in multiple organ dysfunction syndrome

Objective To investigate the mortality, risk factors and effective therapy of acute renal failure with multiple organ dysfunction syndrome. Methods The data of 694 patients with MODS were studied retrospectively, including 441 patients with acute renal failure. Results The incidence of ARF was 63. 5% in MODS, and the mortality of 59.7% was high. Our study showed that in MODS with ARF group, the age, rate of respiration, blood sodium, blood sugar,CO are high and the blood pressure,CVP, pH, BE, peripheral vascular resistance was low, contrasting to MODS without ARF group. After Logistic regression analysis, the main mortality risk factors were age, BUN,SBP,CVP,oxygenation index,PaCO2, but blood purification,nutrition through gastric intestine are protective factors. Conclusion The mortality of MODS with ARF is high, and the blood purification, nutrition through gastric intestine maybe reduce the mortality.