急性肾功能衰竭误漏诊临床观察及肾活检的意义

Renal biopsy analysis and misdiagnosis investigation of patients with acute renal failure

目的探讨急性肾功能衰竭误漏诊原因,提高急性肾功能衰竭诊断水平。方法分析入院前诊断与最终诊断的符合率,寻找误漏诊原因,总结肾活检后诊断和治疗的修正率及早期治疗对预后的影响。结果52例急性肾功能衰竭病例中17例(32.7%)存在病因误诊,肾活检后有29例(55.8%)治疗有较大变动。结论临床上有相当部分急性肾功能衰竭的病因被误诊,应及时肾活检,以免延误治疗。

[Objective] To improve the diagnostic accuracy of acute real failure （ARF） by analyzing the causes of misdiagnosis. [Methods] Compared the correlation between admission and final diagnoses, found out the possible causes of misdiagnosis and summarized the influence of early diagnosis and treatment on prognosis. [Results] In 52 ARF patients,17 cases（32.7%） were misdiagnosed, and treatment therapy was changed in 55.8%（29/52） cases after biopsy. [Conclusion] ARF is often misdiagnosed and renal biopsy is very helpful in differentiation.