小儿慢性肾功能衰竭的临床特点及远期预后影响因素  

Analysis of clinical features of children with chronic renal failure and relative factors of long-term prognosis

作　　者：倪瑞芹[1] 陈蓉[1] 裴秀梅[1] 高翠美[1] 

机构地区：[1]山东省潍坊市妇幼保健院,261000

出　　处：《中国实用医刊》2017年第21期20-23,共4页Chinese Journal of Practical Medicine

摘　　要：目的分析小儿慢性肾功能衰竭的临床特点，探讨影响患儿远期预后的相关因素。方法回顾性分析106例慢性肾功能衰竭患儿的临床资料，总结其临床特点，通过单因素和COX回归分析法分析影响预后的相关因素。结果106例患儿中初诊诊断准确率为23.58%，发病原因以先天性病因（38.68%）和获得性病因为主（40.56%）；常见临床症状为倦怠乏力（65.09%）、纳差（68.87%）、水肿（49.06%）、呕吐（36.79%）；患儿1、2、3、4年存活率分别为72.64%、66.98%、61.32%和50.94%。治疗方式、尿毒症脑病、水钠潴留、大量蛋白尿、高磷血症、高氯血症、高钾血症、水肿、少尿与患儿预后密切相关（P〈0.05）。COX回归分析结果显示，高钾血症、水钠潴留、治疗方式、高磷血症及大量蛋白尿为慢性肾功能衰竭患儿预后的独立危险因素（P〈0.05）。结论慢性肾功能衰竭远期生存率较低，且发病初期易误诊，大量蛋白尿、水钠潴留、高钾血症、高磷血症、治疗方式为影响慢性肾功能衰竭患儿远期预后的主要因素。Objective To analyze the clinical characteristics of children with chronic renal failure, and to investigate the related factors of long-term prognosis.Methods The clinical data of 106 children with chronic renal failure were analyzed retrospectively, and the clinical characteristics of children were summarized; relative factors of prognosis were analyzed by single factor and COX regression analysis.Results The accuracy of primary diagnose was 23.58% in 106 cases, and congenital （38.68%） and acquired etiology （40.56%） dominated the main place of disease causes; the common clinical symptoms were fatigue （65.09%）, anorexia （68.87%）, edema （49.06%） and vomiting （36.79%）; survival rates in 1, 2, 3 and 4 years were 72.64%, 66.98%, 61.32% and 50.94%, respectively; the treatment mode, uremic encephalopathy, water and sodium retention, a large number of proteinuria, hyperphosphatemia, hyperchloremia, hyperkalemia, edema, less urine had close correlation with prognosis of patients （P〈0.05）; COX regression analysis showed that hyperkalemia, water and sodium retention, treatment mode, a large number of proteinuria, hyperphosphatemia were the independent risk factors of long-term prognosis of chronic renal failure.Conclusions The long-term survival rate of chronic renal failure has low long-term survival rate, and it is easy to be misdiagnosed in the early stage; a large number of proteinuria, water and sodium retention, hyperkalemia, hyperphosphatemia, treatment mode are the main factors affecting long-term prognosis of chronic renal failurethe.

关 键 词：慢性肾功能衰竭 儿童 临床特点 远期预后 影响因素 

分 类 号：R726.9[医药卫生—儿科]