血液透析对急性肾衰并发症及病死率的影响

Influence of Hemodialysis on Its Complications and Fatality Rate of Acute Renal Failure

目的：探讨血透与非透析疗法对急性肾衰（ＡＲＦ）并发症及病死率的影响，分析主要死因变化。方法：对９９例ＡＲＦ患者，分血透（ＨＤ）组（５０例）与非透析（ＮＤ）组（４９例）进行回顾研究。分析并发症与病死率的关系及直接死因。结果：病死率：ＮＤ组４６．９％，ＨＤ组２０．０％（Ｐ＜０．０１）。并发症：心衰、心律紊乱、中枢神经系统病变，ＨＤ组明显低于ＮＤ组；感染、多脏衰（ＭＳＯＦ）和消化道出血无统计学意义。主要死因：ＮＤ组依次为ＭＳＯＦ、心衰及心律紊乱；ＨＤ组感染居第１，ＭＳＯＦ次之。结论：血液透析通过有效地防治心衰、心律紊乱及中枢神经系统并发症而降低ＡＲＦ的病死率，但不能降低ＡＲＦ感染发生率，感染为ＡＲＦ患者最主要的并发症和首位死因。

Objective:To study the influence of hemodialysis therapy and non-hemodialysis therapy on the complications and fatality rate of acute renal failure(ARF) and to analyze its variation of death cause.Method:Ninety-nine ARF patients were retrospectively studied.Hemodialysis-treated group(HD) included 50 patients and non-hemodialysis-treated group(ND) 49.A direct death cause and relation of fatality rate to complications were analyzed.Results:The fatality rate was found to be 46.9% in ND group and 20.0% in HD group.The incidence of heart failure,arrhythmia and the lesions of centrol nervous system in HD group was significantly lower than that in ND group.No statistical significane was found with regard to infection,multiple system organ failure(MSOF) and digestive tract bleeding between the two groups.In order of incidence,the main death cause included MSOF,heart failure and arrhythmia in ND group,in HD group,infection was the first cause of death and the MSOF was the second.Conclusion:The fatality rate of ARF is reduced by the hemodialysis which effectively prevents the heart failare,arrhythmia and the complictions of central nervous system.But it can't reduce the incidence of infection.That's why the infection became a major compliction and the first death cause of ARF.