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目的 :研究分析重症监护病房(intensive care unit,ICU)内急性肾损伤患者的预后指标,为临床治疗和理论研究提供参考依据。方法:对本院2011年2月—2014年2月200例ICU患者的资料进行回顾性分析,根据WHO关于急性肾损伤的诊断标准进行分期,分析患者肾功能、脏器衰竭、排尿量、血常规等资料,采用Logistic回归分析患者肾损伤预后指标。结果:ICU中45%(90/200)的患者出现急性肾损伤,病因多为感染导致,占63.33%(57/90)。88例死亡,急性肾损伤死亡的占33.04%(37/88),合并症病死率高于单纯肾损伤的患者。肾脏替代治疗后患者的肌酐、血钾、排尿量等与治疗前比较均有所改善。回归分析结果显示经过治疗患者高血钾、高APACHEⅡ评分和器官衰竭数量≥2个是肾损伤患者死亡的危险因素,肾脏替代治疗是保护因素。结论:ICU患者患有急性肾损伤几率较高,病死率较高。经过治疗,高血钾、高APACHEⅡ评分和器官衰竭数量≥2个是肾损伤患者死亡的危险因素,肾脏替代治疗是保护因素,但与病死率无关。
Objective: To study the prognostic indicators of patients with acute kidney injury in intensive care unit (ICU), and provide reference for clinical treatment and theoretical research. Methods: The data of 200 ICU patients from February 2011 to February 2014 in our hospital were retrospectively analyzed. According to WHO criteria for diagnosis of acute kidney injury, the patients were divided into three groups according to their diagnostic criteria: renal function, organ failure, urine output, blood Routine and other data, the use of Logistic regression analysis of patients with renal damage prognostic indicators. Results: Acute renal injury occurred in 45% (90/200) of the ICU patients. Most of the causes were infections, accounting for 63.33% (57/90). 88 died, 33.04% died of acute kidney injury (37/88), and the mortality rate of comorbidity was higher than that of simple renal injury. Renal replacement therapy in patients with creatinine, potassium, urine output and other improvements compared with before treatment. Regression analysis showed that the treated patients with hyperkalemia, high APACHE Ⅱ score and organ failure ≥ 2 were risk factors for death in patients with renal injury, renal replacement therapy is a protective factor. Conclusion: Patients with ICU have a higher risk of acute kidney injury and higher mortality. After treatment, hyperkalemia, high APACHE Ⅱ scores and organ failure ≥ 2 are risk factors for death in patients with kidney injury. Renal replacement therapy is a protective factor, but has nothing to do with mortality.