医院获得性急性肾功能衰竭的临床特点分析

The clinical analysis of hospital acquired acute renal failure

目的探讨医院获得性急性肾功能衰竭（HA-ARF）的临床特点。方法回顾性分析我院5年间103例住院期间出现ARF患者的临床特点并与同期院外获得性ARF（CA—ARF）比较。结果HA-ARF103例中，发病率以60～74岁最高，占32．04％；病因以感染因素最多（33．01％）．其次为心脑血管疾病（17．48％）、急性血容量减少（14．56％）和手术因素（9．71％）；34．95％合并其他器官功能衰竭，死亡率为39．80％，均比CA—ARF组高。结论HA-ARF的主要病因是感染、心脑血管疾病、急性血容量减少和大手术，其死亡率较高，积极进行病因治疗和透析疗法是抢救患者的主要手段。

Objective To expolre the clinical characteristic of hospital acquired acute renal failure （HA- ARF）. Methods To retrospectively analyse the clinical datas of 103 patients who were suffered from acute renal failure in the duration of hospital stay within 5 years, which was compared with the homeochronous community-acquired acute renal failure（CA-ARF）. Results In the 103 cases of HA-ARF,the incidence rate was 32.04 % in the major age range from 60 to 74 years old,infection was the most important factor（33.01% ）, then other factors were cardial and cerebrovascular diseases（ 17.48 % ）, acute hypovolemia （14.56 % ） and operation （9.71% ） ;The complicating other organ nonfunction（34.95% ）,and the mortality rate was 39.80%, all the factors in HA-ARF were higher than that in CA-ARF. Conclusion The main factors of origin in HA-ARF are infection, cardial and cerebrovascular disease, acute hypovolemia and operation. The mortality rate of this disease is higher. Etilogical treatment promptly and dialysis regimen are the main means to rescue these patients.