312例急性肾功能衰竭患者的临床特征与预后的关系

Study on the Relationship Between Clinical Features and Prognosis of 312 Acute Renal Failure Patients

【目的】探讨急性肾功能衰竭(acute renal failure,ARF)的病因特点、治疗情况及其与预后的关系,为临床治疗ARF提供依据。【方法】回顾性分析312例ARF的临床资料,采用逻辑斯蒂回归分析方法分析各种因素与患者预后的关系。【结果】312例ARF中内科病因引起的占55.4%,其次为外科病因,占29.8%,肿瘤病因占10.9%,儿科和妇产科病因所占的比例较低。老、少患者的病死及未愈率之和均高于青壮年(P<0.05);少尿型、非少尿型ARF死亡及未愈率合计分别为60.1%和34.7%,两者相比差异有显著性(P<0.01);无并发症与合并多脏器功能衰竭的ARF病死及未愈率合计分别为43.9%和90.2%,两者相比差异有显著性(P<0.01)。【结论】内科病因引起的ARF居首位,其次为外科病因和肿瘤;老、少患者,少尿型患者,合并多脏器功能衰竭患者病死率较高;透析可降低ARF患者的病死率。

[Objective]In order to investigate the relationship between clinical features and prognosis for providing clinical evidence for treating acute renal failure （ARF）. [Methods]Three hundred and twelve patients with ARF were retrospectively investigated. The relationship between prognosis and clinical features was studied with logic regression analysis. [Results] Medical illness was 55.4% of causes leading to ARF, and surgical reason was 29, 8%. The mortality of elderly patients and children was higher than that of young patients. The mortality of oliguric and nonoliguric renal failure were 60. 1% and 34. 7% respectively. The mortality of ARF with multiple organ dysfunction syndrome （MODS） and no complication was 43. 9% and 90. 2% respectively. There was significant difference （ P 〈0. 01）. [Conclusion] Medical illness is the first reason that leads to ARF, and the next is the surgical reason. The mortality of ARF patients with MODS, elder and children was higher. Hemodialysis can decrease the mortality of ARF.