急性肾功能衰竭伴全身炎症反应综合征临床分析

Clinical Analysis of Acute Renal Failure with Systemic Inflammatory Response Syndrome Patients

目的 了解急性肾功能衰竭 (ARF)伴发全身炎症反应综合征 (SIRS)的发病和预后情况 ,并探讨有效的防治措施。方法 回顾性分析 1973.1～ 1998.12间 314例ARF病人。结果 SIRS组患者年龄、死亡率和伴多脏器功能障碍综合征的发生率均显著高于非SIRS组 ;严重感染是伴SIRS的ARF的主要原因 ,占 2 4 .7% ;SIRS和非SIRS组患者直接死于ARF本身并发症的无差别 ;透析治疗者死亡率显著低于非透析治疗患者。结论 伴SIRS的ARF预后差 ,目前尚无特别行之有效的治疗措施 。

Purpose. To determine the cause, outcome and effective management of acute renal failure (ARF) with systemic inflammatory response syndrome (SIRS). Methods. retrospective analysis of 314 hospitalized patients of ARF between 1973.1 and 1998.12. Results. Major causes of ARF with SIRS were infectious diseases (24.7%). The morbidity of multiple organ dysfunction syndrome and mortality were much higher in SIRS group than that in non-SIRS group. There was no difference in the death from metabolic complications of ARF between two groups. The mortality of patients treated by dialysis was lower than that patients treated by no-dialysis. Conclusions. The prognosis of ARF with SIRS was very poor. Maybe dialysis especially continuous renal replacement treatment could improve the outcome.