影响重症监护室急性肾损伤患者预后因素分析

Analysis of the factors influencing the prognosis of patients with acute kidney injury in ICU

目的:对影响重症监护室急性肾损伤(acute kidney injury,AKI)患者预后因素进行分析。方法:选取在重症监护室进行治疗的重症患者384例,选取发生急性肾脏损伤患者100例为观察组,选取未发生急性肾损伤患者100例为对照组,进行对比,分析其影响预后因素。结果:在我院重症监护室内发生急性肾损伤的比例为26.0%,其中肾前性71例(71.0%);肾性23例(23.0%);肾后性6例(6.0%)。在急性肾损伤患者中,ICU住院时间、28 d病死、慢性肺病、手术、脓毒血症、机械通气的比例和基础肌酐值与未发生急性肾损伤患者对比均增加(P﹤0.05)logistic回归分析结果显示慢性肺病、脓毒症、手术、机械通气、基础肌酐值为影响急性肾损伤患者预后的危险因素。结论:对于存在上述危险因素的患者应给予重视,积极干预,采取有效治疗,从而降低病死率。

Objective：To analyze the factors influencing the prognosis of patients with acute kidney injury （AKI） in intensive care unit （ICU）. Methods ：384 patients in the ICU were selected for the study, including 100 cases of AKI, and other 100 cases without AKI to be compared ,the factors influencing the prognosis analyzed. Results：The proportion of AKI in the ICU was 26.0 %, among which there were 71 cases of prerenal failure （ 71.0 % ）, 23 cases of renal neutral failure （23.0 % ） and 6 cases of postrenal failure （6.0 % ）. Compared with patients without AKI, ICU hospital stay, the proportion of 28 days mortality, chronic lung disease, surgery, sepsis, mechanical ventilation, creatinine value were increased, difference was statistically significant （ P 〈 0.05 ）. Logistic regression analysis showed that chronic lung disease, sepsis, surgery, mechanical ventilation, the basic creatinine value were risk factors of AKI prognosis. Conclusion： Patients with these risk factors should be given full consideration, actively intervened and treated with effective measures to reduce mortality.