ICU中脑部疾病发生急性肾损伤的临床分析

刘成; 邹琪; 赵飞

doi:10.16766/j.cnki.issn.1674-4152.2016.11.010

ICU中脑部疾病发生急性肾损伤的临床分析

doi: 10.16766/j.cnki.issn.1674-4152.2016.11.010

蚌埠医学院第一附属医院ICU, 安徽蚌埠 233004

基金项目:

安徽省“十二五”临床重点专科建设计划首批建设项目(卫科秘[2013]228号)

安徽省2015年公益性技术应用研究联动计划项目(15011d04052)

详细信息

通讯作者:
刘成,E-mail:liucheng1999@163.com

中图分类号: R651.15;R742;R692
计量
- 文章访问数: 95
- HTML全文浏览量: 17
- PDF下载量: 1
- 被引次数: 0
出版历程
- 收稿日期: 2016-01-20

Clinical analysis of acute kidney injury with the brain diseases in ICU

ICU, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, China

摘要

摘要: 目的探讨ICU中脑部疾病治疗过程中发生急性肾损伤(AKI)时影响分期的危险因素和影响其预后的因素。方法收集2011年6月—2015年7月ICU住院患者病历资料，筛选出所有脑部疾病发生AKI的患者，共59例。收集符合条件的脑部疾病发生AKI患者的一般资料[包括年龄、性别、格拉斯哥昏迷评分(GCS评分)、有无慢性疾病]和各种指标(包括肾功能指标、有无休克、是否手术、是否使用肾毒性药物、甘露醇总量，以及预后、住ICU天数和住院费用)。通过急性肾损伤网络(AKIN)诊断标准进行分级，观察患者住院28 d时和出院时的肾脏预后与患者的预后关系,通过单因素方差分析了解AKI与患者预后的关系,并且通过Logistic回归分析研究出影响疾病分期和预后的危险因素。结果统计分析得出AKI Ⅰ、Ⅱ、Ⅲ级分别占39.0%、30.5%和30.5%，其治愈或好转患者比例占45.8%，而未愈合患者比例占54.2%，所有患者的GCS评分5(4,7)分，甘露醇使用总量1 000(400，1 440) g，使用肾毒性药物的患者22例，所有患者住ICU 14(13，23) d，总花费5.7(4.5,8.6)万元。影响AKI分期的危险因素为：GCS评分、肾毒性药物是否使用和有无合并慢性疾病，影响其转归的因素为：年龄、GCS评分、是否使用肾毒性药物、性别和AKI分级，并且AKI分期越高，住院时间和花费越高。结论脑部疾病并发急性肾损伤的病死率较高，高度重视其各种危险因素，要求临床医师对脑部疾病导致的AKI进行早期预防和早期诊断，能够改善其预后，减轻患者经济负担等。
- 脑部疾病 /
- 急性肾损伤 /
- 危险因素
Abstract: Objective To explore the risk factors for acute kidney injury in ICU during the course of treatment of brain diseases and its prognostic factors. Methods The medical records of hospitalized patients in ICU from June,2011 to July,2015 were collected,all AKI with the brain diseases were selected,a total of 59 cases.According to the conditions of the brain disease patients with AKI,we collected the general data (including age, gender,Glasgow Coma Scale, with or without chronic diseases.), the special data (including indexes of renal function, whether there is shock,surgery,whether there is the use of nephrotoxic drugs, the total amount of mannitol), as well as the prognosis,ICU stay and costs.Through the AKIN diagnostic criteria is graded, the relationship between the prognosis of the patients and the prognosis of the patients at 28 days and discharged are observed, the relationship between AKI and prognosis of patients are analyzed by single factor variance analysis,and the risk factors for disease stage and prognosis are analyzed by Logistic regression analysis. Results AKI Ⅰ,Ⅱ and Ⅲ were accounted for 39.0%,30.5% and 30.5%,respectively,the proportion of cured or improved is 45.8%,and the proportion of non-healing patients accounted for 54.2%.GCS score of 5(4,7) of all patients,1 000(400,1 440) of the total use of mannitol,22 patients with renal toxicity drugs,ICU length of stay is 14(13,23)d,a total cost of 5.7(4.5,8.6) million.Risk factors for AKI staging:GCS score,whether there is the use of nephrotoxic drugs and whether having chronic diseases,factors affecting the outcome such as Age,GCS score,whether there is the use of nephrotoxic drugs,sex and AKI classification,and the higher the AKI staging,the higher hospitalization time and costs. Conclusion There is a high mortality rate in patients of acute kidney injury with the brain diseases in ICU.The clinicians require attaching great importance to its various risk factors, to make early prevention and early diagnosis of brain disease with AKI,which can improve the prognosis and reduce the economic burden of patients.
- Brain /
- Acute renal failure /
- Risk factors