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小儿脓毒症并发急性肾功能衰竭临床特点和预后因素分析 被引量:5

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摘要 目的探讨小儿脓毒症并发急性肾功能衰竭患儿的临床特点和影响预后的因素。方法回顾分析2003年6月至2008年11月在首都医科大学附属北京儿童医院肾内科住院的脓毒症合并肾功能衰竭患儿的临床资料。结果脓毒症并发急性肾功能衰竭者41例,占同期急性肾功能衰竭患儿的17.01%。均发生多脏器衰竭,最易累及肾脏、血液、神经系统和肺脏,其中3个以上多脏器衰竭发生率为70.7%。入院后积极给予抗生素静点、丙种球蛋白冲击、输注血浆以及不同形式的血液净化治疗,32例痊愈出院,死亡9例,病死率为21.95%。单因素分析发现原发或继发免疫低下、呼吸衰竭、急性肾小管坏死、病情严重性指数(ATN-ISI)积分、合并先天性心脏病和泌尿系畸形等基础病变、是否及时采取血液透析、持续血液滤过以及丙球治疗为影响其预后的因素。多因素回归分析结果显示ATN-ISI积分为其独立危险因素。结论小儿脓毒症合并急性肾功能衰竭预后差,尽早进行血液净化和丙球支持疗法可显著改善患儿预后。
出处 《中国实用儿科杂志》 CSCD 北大核心 2009年第6期478-479,共2页 Chinese Journal of Practical Pediatrics
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