妊娠期非肾后性急性肾功能衰竭分析

Analysis of acute non-post renal failure in pregnancy period

目的：分析妊娠期伴有急性肾功能衰竭患者的临床资料,探讨急性肾衰孕妇病理生理状况及相关生化因素、妊娠结局。方法：收集2003年12月~2011年7月间16例我院妊娠期急性肾功能衰竭患者的临床资料,所有患者均行血常规、凝血功能、肝肾功、白蛋白、血脂、血糖、电解质检查,并对妊娠结局进行分析。结果：所有16例患者急性肾衰的发生均在孕中期之后,均为肾前性和/或肾性肾功能衰竭,在肾功能明显恶化的同时,伴发有血液生化、凝血功能的明显改变。有12例患者合并有妊娠期高血压疾病,4例患者剖宫产终止妊娠,12例阴道分娩,16例患者均无胎儿存活。有6例患者合并胎盘早剥而出现产科难以控制的DIC转ICU治疗,无患者死亡。结论：妊娠期合并急性肾功能衰竭是一种妊娠期少见的合并症,胎儿预后极差,孕母在合并多器官功能改变时预后迅速恶化。

Objective：To analyze the clinical data including biochemical markers and pregnant outcome of the patients with acute renal failure in pregnancy period.Methods：Laboratory check such as urine and vein blood sample were tested as well B mode ultrasound seaning in all patients.Results：Amount to 16 cases with acute renal failure were analyzed among 72780 cases of pregnant women.All acute renal failure happened in second trimester later.No post acute renal failure patient was observed.Twelve cases accompaned gestational hyperten- sion disorder.Twelve cases gravidity ended in vaginal delivery by a kinds of induced ways and the other 4 patients with cesarean section.No fetus survival regretly.Six cases patients come into intensive care unit（ICU） owing to uncontrollable disseminated intravascular coagulation （DIC）secondory to placenta abruption.Conclu- sion：Acute renal failure is very rare of affairs in prenancy period.The prognosis of fetus is awful.Maternal health rapidly deteriorate complicating multiple organic impairs.