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目的探讨老年急性肾功能衰竭(ARF)的病因及预后因素。方法回顾性总结110例老年ARF的临床资料,并取同期住院的110例非老年ARF临床资料作对照,对比分析两组患者的病因、生化指标、原发慢性病及其预后。结果两组ARF病因明显不同:①老年组肾前性因素以各种感染(46.51%)、心血管疾病(34.88%)居多,非老年组则以创伤性因素(75.0%)为主;②老年组肾炎因素多见于药物中毒(61.29%)和生物中毒(25.81%),非老年组以急性肾脏疾病为主(79.59%);③老年组病死率为40.91%显著高于非老年组的15.45%(P<0.001)。影响老年组ARF预后因素主要是MODS及原发慢性病。结论根据老年ARF病因采取相应预防措施,积极防治MODS和原发慢性病,是降低老年ARF发病率和病死率的关键措施。
Objective To investigate the etiology and prognostic factors of senile acute renal failure (ARF). Methods The clinical data of 110 cases of elderly ARF were retrospectively reviewed. The clinical data of 110 cases of non-elderly ARF hospitalized in the same period were compared. The etiology, biochemical indexes, primary chronic diseases and their prognosis were compared between the two groups. Results The etiology of ARF in the two groups was significantly different. ①The incidence of prerenal factors in the elderly group was 46.51%, cardiovascular disease was the most common (34.88%), and the non-elderly group was mainly traumatic factor (75.0%). ② The elderly Nephritis was more common in drug poisoning (61.29%) and organism poisoning (25.81%) than in non-elderly patients (79.59%). The mortality in the elderly group was 40.91%, significantly higher than that in the non-elderly group (15.45% (P <0.001). The prognostic factors of ARF in the elderly group were mainly MODS and primary chronic disease. Conclusion According to the causes of ARF, taking appropriate preventive measures and actively preventing and treating MODS and primary chronic diseases are the key measures to reduce the morbidity and mortality of ARF in the elderly.