88例急性肾功能衰竭临床病因分析

Analysis of Etiology for Acute Renal Failure in 88 Patients Treated by Hemodialysis

目的 探讨急性肾功能衰竭的临床病因、分型及治疗效果。方法 回顾性分析本院所有透析治疗的 88例急性肾功能衰竭 (ARF)病人的临床病历资料、肾衰原因、肾衰类型及治疗效果。结果 ARF有肾前性因素者达 78 14% ,单纯肾实质性病变占 2 0 4 5% ,肾后性原因仅占 1 14% ;药物引物的ARF占 2 0 4 5% ,以氨基糖甙类抗菌素多见 (13/ 18) ;病人死亡率为 30 97% ,完全治愈率仅为 37 5%。结论 注意血容量不足的症状与体征 ,及时扩容 ,保证肾供血充足可减少ARF的发生及药物性肾毒性的出现 ;需透析治疗的ARF病人治疗效果欠佳。

Objective To research the pathogenesis,clinical types and therapeutic effects of acute renal failure.Method All eighty-eight patients with acute renal failure(ARF) treated by hemodialysis were analyzed retrospectively in our hospital for last more than 4 years,and the etiology,clinical types of ARF and the clinical outcome of treatment were summarized.Results ARF patients with pre-renal reasons were 78 41%,single renal cortex and/or medullary disease leading to ARF were 20 45%,post-renal reason was only 1.14%;ARF induced by drugs were 20 45%,the main drugs were aminoglycosides(13/18);mortality rate was 30 97%,but the complete recovery rate was only 37 5%.Conclusion Clinical doctors must be careful observe the patients complications decrasing signs of the blood volume and supplementing blood volume in timely to avoid renal ischemia,these treatment may prevent ARF and kidney lesion induced by drugs,but the prognosis of patients with hemodialysis in ARF is not good.