慢性尿毒症恶化因素分析及其治疗

THE TREATMENT AND ANALYSIS IN CHRONIC UREMIA WITH DETERIORATION FACTORS

本文对164例慢性尿毒症进行临床分析,发现有各种尿毒症恶化因素者142例(86.5％)。其中感染57例(34.8％)居首位,其次是水电解质紊乱33例(20.1％),第三位是恶性高血压21例(12.8％);而完全性房室传导阻滞7例(4.2％),虽占比例较少,但在出现后72小时内全部死亡,提示其预后最险恶。142例中有94例(66.2％)经矫治恶化因素后肾功能显著改善。因此认为恶化因素影响患者的预后,如能及时发现与处理,可望降低死亡率。文中并简要讨论慢性尿毒症并发完全性房室传导阻滞的发生机制及临床意义。

In this article, we analysed 164 cases of chronic uremia which admitted in our hospital from 1981 to 1987. We found that there were deterioration factors in 142 cases (86.5%). Among them, infection was in 57 cases (34.8%), disturbance of water and electrolyte in 33 cases (20.1%), deterioration hypertension in 21 cases (12.8%). We also found that complete atrioventricular block (AVB) in 7 cases (4.2%) all of the 7 cases died in 72 hours, which suggests that the prognosis of the cases with complete AVB in uremia is the worst. We observed that renal function in 94 cases out of 142 cases with deterioration factors had remarkably been improved after the treatment to the deterioration factors. We think that though deterioration factors affect the prognosis of the patients with chronic uremia, if the deterioration factors could be found and to be treated as soon as possible, mortality may be decreased. In this article, we also discussed briefly the mechanisms and clinical significances of complete AVB in chronic uremia.