外科危重病人并发急性肾功能损伤死亡危险因素分析

A study on the risk factors of critically ill surgical patients with AKI

目的探讨外科危重病人并发急性肾功能损伤死亡的危险因素。方法通过回顾性分析2008年5月—2010年5月我院普外科ICU收治的发生急性肾功能损伤(Acute kidney injury,AKI)的22例患者的临床资料,应用Logistic回归对相关数据进行分析。结果 22例发生急性肾损伤的患者,伴有原发性高血压、糖尿病,合并呼吸衰竭、MODS、休克的死亡率较高,Logistic回归分析显示,急性肾功能损伤的患者合并MODS(P=0.005)和呼吸衰竭(P=0.020)是与死亡率显著相关的危险因素,伴MODS的患者,衰竭器官数越多,死亡率越高。结论外科危重病人急性肾功能损伤的死亡率很高,合并MODS和呼吸衰竭是死亡的显著性相关因素,对于高危患者,立足预防,早期综合治疗,尽可能的阻断或减缓MODS的进程,改善呼吸功能,对于提高生存率是有意义的。

Objective To investigate the risk factors of death in critically ill surgical patients with acute renal injury（AKI）.Methods The study reviews the history of the 22 AKI patients in our SICU form May 2008 to May 2010.The logistic regression analysis was conducted to collect the information and analyze the data.Results The mortality rate is high in 22 AKI patients who have essential hypertension,DM,complicated with respiratory failure,MODS and shock.In the logistic regression analysis,the MODS（P=0.005） and respiratory failure（P=0.020） are the risk factors of the mortality.In MODS patients,the more dysfunction organs,the higher mortality rate is.Conclusion The mortality rate is high in critically ill surgical patients with AKI.AKI complicated with MODS and respiratory failure is significant associated with mortality rate.In curing the patients with high risk factors,we should do the prevention and give them combined therapy earlier to block the proceeding to MODS earlier,and improve the survival rate.