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新生儿急性肾损伤的早期诊断临床分析 被引量:8

Early diagnosis of neonatal acute kidney injury in NICU
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摘要 目的探讨新生儿重症监护病房(NICU)中新生儿急性肾损伤(AKI)发生率和病死率,比较不同的AKI早期诊断标准评估新生儿AKI的发生率和病死率的差异,探讨新生儿AKI早期诊断标准的重要性。方法采用前瞻性队列研究,将2012年6月至2012年8月就诊于复旦大学附属儿科医院NICU的新生儿作为研究对象,分别收集并记录每小时尿量以及入院当天、48 h内的血肌酐等临床、实验室指标及治疗等情况,依照AKIN 2005年儿童AKI和AKIN 2012年新生儿AKI早期诊断标准进行分组,比较新生儿AKI的发病情况、病死率及临床特点。结果按照AKIN 2005年儿童AKI的早期诊断标准共确诊AKI患儿20例,发生率为14.71%;在AKI组中,死亡9例,病死率为45%。按照AKIN 2012年新生儿早期诊断标准共确诊AKI患儿35例,发生率为25.73%;其中AKI新生儿死亡18例,病死率为51.43%;2012年AKIN早期诊断标准对新生儿AKI诊出率明显高于2005年的标准,两种早期诊断标准所致的新生儿AKI发生率差异存在统计学意义(P=0.024),但两种诊断标准所致的病死率差异无统计学意义(P=0.646)。结论新生儿AKI在NICU中发生率、病死率高,诊断困难,AKIN 2012年新生儿AKI早期诊断标准较AKIN 2005年儿童AKI早期诊断标准有助于新生儿AKI的早期诊断。 Objective To investigate the morbidity and mortality of neonatal AKI in NICU,evaluate the the performance of the different AKI diagnosis criteria of the Acute Kidney Injury Network (AKIN) and to study the importance of early diagnosis criteria for neonatal AKI. Methods This is a prospective cohort study performed in NICU,Children Hospital of Fudan University. We prospectively followed the neonates(less than 28 days) admitted from June1st,2012 to August 31,2012,until their discharge or death. For all the neonates we collected the clinical data at admission. Results AKI was diagnosed in 35 neonates,the incidence of neonatal AKI was 25.73% according to the diagnosis criteria of AKIN in 2012. The mortality of neonatal AKI group was 51.43%(18/35). Meanwhile,AKI was diagnosed only in 20 neonates,incidence of AKI being 14.71% in the same study with the other diagnosis criteria of AKIN in 2005 and the mortality of neonatal AKI group was 45%(9/20). Conclusion AKI is a common and severe clinical problem in NICU with high morbidity and mortality in NICU and is hard to diagnose. The criteria of AKIN in 2012 can improve the early diagnosis of newborn AKI in PICU.
出处 《中国实用儿科杂志》 CSCD 北大核心 2018年第2期122-126,共5页 Chinese Journal of Practical Pediatrics
关键词 新生儿 新生儿监护病房 急性肾损伤 发生率 病死率 neonate neonatal intensive care unit (NICU) acute kidney injury (AKI) incidence mortality
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