RIFLE标准在肾科会诊术后急性肾损伤中的应用  

RIFLE criteria in nephrological consultation in patients with acute kidney injury after surgery

作　　者：曹琦琪 黄军悦[2] 谌卫[3] 张懿[3] 郭志勇[3] 

机构地区：[1]海军军医大学学员大队,上海200433 [2]甘肃省人民医院肾内科,甘肃兰州730000 [3]上海长海医院肾内科,上海200433

出　　处：《临床荟萃》2017年第10期861-864,共4页Clinical Focus

摘　　要：目的探讨RIFLE标准在外科手术后急性肾损伤病例中肾科会诊中的应用。方法回顾性分析术后发生急性肾损伤并约请肾科会诊的患者179例。根据RIFLE标准进行分组,其中危险组12例(6.7%)、损伤组35例(19.6%)、衰竭组132例(73.7%),比较3组院内病死率、住院时间等预后指标。结果总院内病死率为32.4%,随访60天后,总病死率为38.5%。衰竭组病死率为37.9%,较危险组(16.7%)及损伤组病死率(17.1%)均明显升高。3组住院时间比较差异无统计学意义。结论肾科医生早期参与诊疗并提出恰当准确的会诊意见的病例通常获得较好的预后,RIFLE标准有一定的指导意义。Objective To evaluate the application of RIFLE criteria in the nephrological consultation in patients with acute kidney injury after surgery.Methods A total of 179 patients with acute kidney injury after surgery were retrospectively analyzed,and then classified as risk group,injury group,and failure group according to the RIFLE criteria based on the situation at the time of consultation.Mortality,hospital stay and others prognosis indexes among three groups were compared.Results Overall mortality was 32.4% and 60days＇ follow-up mortality was 38.5%.And the mortality in failure group（132cases） was 37.9% compared with risk group（16.7%） and injury group（17.1%）.There was no significant difference in hospital stay among three groups.Conclusion In this setting,the survival rate might be improved with early nephrological consultation and appropriate therapeutic measures.The RIFLE classification was a useful tool during the consultation.

关 键 词：急性肾损伤 转诊和会诊 预后 

分 类 号：R692.5[医药卫生—泌尿科学]