急性肾功能衰竭137例病因及预后的分析  

The study of relationship between etiology and prognosis in 137 patients with acute renal failure

作　　者：周树录[1] 杨秀川[1] 王莉[1] 何强[1] 王志静[1] 

机构地区：[1]四川省人民医院肾内科,成都610071

出　　处：《医学科技》2001年第1期15-17,共3页

摘　　要：目的:探讨急性肾功能衰竭的病因及与预后的关系。方法:对 137例急性肾功能衰竭患者的临床资料进行回顾性分析。结果:137例急性肾功能衰竭病例中,病因以肾实质性因素最多(111例),其中毒蕈中毒56例、鱼胆中毒 21例、各种肾炎 10例。其次为肾前性因素(19例),包括败血症及感染性休克 13例、产后大出血 3例。肾后性 4例。在全部病例中,以农民病员居多(72例)。死亡19例,其中因败血症、感染性休克及产后大出血导致者共12例。结论:毒蕈中毒和鱼胆中毒是急性肾功能衰竭的主要病因,肾前性因素是导致死亡的主要原因。Objective: To study the relationship of etiology and prognosis in patients with acute renalfailure(ARF). Methods: The data of 137 patients with ARF were studied by retrospecive analysis. Results: The causes were: prerenal disorders (19) including 13 with septicemia and infectious shock, 3with postpartum hemorrhage; intrinsic reanal disorders (111) including 56 with mushrooms poisoning. 21with fish bile poisoning; postrcnal obstruction (4) and others which were unclear (3). Chinical manifes-tations and complications included: oliguria (129), infections (20), uremic encephalopathy (6), con-gestive heart faliure (6) and gastrointestinal hemorrhage (4). The experimental assessments were: bloodurea nitrogen(BUN) 30.20±14.14 mmol/L, serum creatinine 1295.83±519.17 μmol/L, hyperkalemia(29), hypokalemia (55), metabolic acidosis (116). All of these patients were managed with measurescorrecting imbalance of water, electrolytes, acids and bases as well as diuretics. 64 patients were given 2to 6 times of hemodialysis and I patient was given peritoneal dialysis for 36 days. Complications weremanaged accordingly. 19 patients died. 10 patients discharged hefore complete recovering. The otherswere cured. Conclusion: The main causes of the 137 patients with ARF were intrinsic renal disorders(111; 81%), particularly mushroom and fish bile poisoning (77; 56.2%). most of the 77 patients werepeasants (52;40%) with a lower degree of health knowledge. For this reason, we emphasize on the im-portance of popularization of health knowledge in rural areas. We also observed that the oliguria phase ofARF caused hy nephrotoxic substances was relatively short and the complications were not severe. Noneof them died. However, the mortality was high in patients with ARF caused hy postpartum hemorrhage,septicemia and infectious shock because of the severe condition. Finally, we should popularize hemodial-ysis and peritoneal dialysis. All of the patients treated with dialysis(except 3 patients died of septicemiaor infectionus shock) recovered. T

关 键 词：急性肾功能衰竭 病因 预后 

分 类 号：R692.5[医药卫生—泌尿科学]