重度脓毒症导致急性肺损伤患者自发性利尿现象的观察分析  

Observation of spontaneous diuresis in the patients with acute lung injury caused by severe sepsis

作　　者：薛晓艳[1] 朱继红[1] 

机构地区：[1]北京大学人民医院急诊科,100044

出　　处：《中国急救医学》2010年第5期410-413,共4页Chinese Journal of Critical Care Medicine

摘　　要：目的分析重度脓毒症导致急性肺损伤（ALI）患者的自发性利尿现象。方法总结我院急诊监护病房三年间的重度脓毒症导致Au患者的资料，分析发生自发性利尿患者的临床特点。结果①在103例重度脓毒症导致的ALI患者中，41例（39．8％）发生自发性利尿现象，表现为患者尿量较前每日增加（1537±502）mL（985～2550mL），持续（5．3±3．5）d（3—10d），自发性利尿后体温下降、呼吸频率下降、氧合指数上升（P均〈0．05），而血肌酐水平无明显变化（P〉0．05）。②自发性利尿患者全部存活，与其他患者比较机械通气时间短、住院时间短（P均〈0．05）。结论重度脓毒症导致Au患者出现自发性利尿现象是病情好转的标志，提示预后良好。Objective To investigate the phenomena of spontaneous diuresis in the patients with severe sepsis - associated acute lung injury. Methods Over a three - year period, one hundred and three ALl patients hospitalized in Emergency Intensive Care Unit were investigated, and we made a series of analysis about clinical characteristics of spontaneously diuretic patients. Results （1） Spontaneous diuresis occurred in 41/103 （ 39. 8% ） patients with ALl induced by severe sepsis. When spontaneous diuresis occurred, the urine volumes augmented by （1537 ± 502 ） mL （range 985 2550 mL）per day, which persisted for （5.3 ± 3.5）d（ range 3 ± 10 d）. Following spontaneous diuresis, their temperature and respiratory rates decreased （ P 〈 O. 05 ）, and oxygenation index increased （ P 〈 O. 05 ）. However, there were no significant differences in serum creatinine levels before and after spontaneous diuresis （ P 〉 O. 05 ）. （2） All spontaneously diuretic patients survived, and their ventilation day and ICU days were shorter than those in the patients without spontaneous diuresis （P 〈 O. 05 ）. Conclusion Spontaneous diuresis is a sign of better outcome in ALl patients caused by severe sepsis.

关 键 词：重度脓毒症 急性肺损伤 自发性利尿 重症监护 

分 类 号：R722.606[医药卫生—儿科]