烧伤合并急性肾功能衰竭的早期指标检测  

Early indicators of acute renal failure in burned patients

作　　者：贺斌[1] 赵柏程[1] 钱利[1] 

机构地区：[1]中南大学湘雅二医院烧伤整形科,湖南长沙410011

出　　处：《现代生物医学进展》2009年第22期4333-4335,共3页Progress in Modern Biomedicine

摘　　要：目的:探讨烧伤合并急性肾功能衰竭(ARF)的早期指标检测以及各种危险因素。方法:选择本院2008年1月～2009年6月收治的75例中重度热烧伤患者,Ⅱ度或Ⅲ度烧伤面积累计20%-70%TBSA。所有患者在人院时、入院后3d、7d、14d和21d检测血清肌酐(Scr)、血尿素氮(BUN)、尿微量白蛋白(mALB)和滤过钠排泄分数(FeNa)。结果:75例烧伤患者中有14例(18.7%)并发ARF,其中10例进行了血液净化治疗。烧伤合并ARF组烧伤面积和脓毒症发生率均明显高于烧伤未合并ARF组(P均<0.05)。烧伤合并ARF组Scr和BUN水平分别在住院7d和14d后明显高于烧伤未合并ARF组(P均<0.05)。烧伤合并ARF组入院时mALB水平已达到正常值3-4倍,21d时达到最大值,在观察期间一直高于烧伤未合并ARF组(P均<0.05)。烧伤合并ARF组滤过钠排泄分数均大于2%。烧伤面积与脓毒症是烧伤后ARF发生的主要危险因素(复相关系数R分别为0.52和0.23,P均<0.05)。结论:烧伤合并ARF与烧伤面积与脓毒症相关,mALB是早期监测ARF的有用指标。Objective：To determine the predictors of acute renal failure （ARF） that occur in major burns. Methods：The data of 75 patients with moderate to severe thermal burn injury-second to third degree with 20% -70% of total body surface area （TBSA） in our hospital were analyzed. All patients were subjected to routine investigations including： Serum creatinine（Scr）, blood urea nitrogen（BUN）, fractional excretion of sodium （FeNa） and microalbuminuria （mALB） on day 0, 3, 7, 14 and 21 of hospitalization. Results： 14 patients （18.7 %） developed ARF, and 10 patients of these required blood purification therapy. The size of burn and occurrence of septicemia in group with ARF were obviously higher than that in group without ARF （P all〈0. 05）. The levels of Scr and Bun in group with ARF from day 7 and day 14 respectively were obviously higher than that in group without ARF （P all〈0. 05）. The group with ARF showed an increase level of mALB that reached 3-4 folds above its normal level on day 0 and reached the maximum on day 21, and it was obviously higher than that in group without ARF in the period of observation （P all〈0. 05）. FeNa was above 2% in all cases with ARF. Burn size and occurrence of septicemia were the only risk factor of ARF using multiple regression analysis （R 0.52 and 0.23 respectively, P all〈0. 05）. Conclusions： In this study, ARF is related to the size of burn and occurrence of septicemia. mALB is a useful early indicator for prediction of renal outcome.

关 键 词：烧伤 肾功能衰竭 尿微量白蛋白 

分 类 号：R644[医药卫生—外科学]