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目的:总结急性肾衰竭(acute renal failure,ARF)的病因特点、治疗情况及其与预后的关系,探讨临床治疗对策。方法:回顾性分析453例ARF的临床资料,采用逻辑斯蒂回归分析方法分析各种因素与预后的关系。结果:内科病因引起的ARF占53.6%,其次为外科病因占32.0%,肿瘤病因占9.9%,儿科和妇产科病因占较少比例。透析前血尿素氮水平越高、血清肌酐升高至开始透析的时间越长,患者死亡的相对危险度越大。老、少患者的病死率高于青壮年(P<0.05);少尿型、非少尿型ARF病死率分别为50.7%和15.4%(P<0.01);无并发症与合并多脏器功能衰竭的ARF病死率分别为28.2%和78.4%(P<0.01)。结论:内科病因引起的ARF居首位,其次为外科病因和肿瘤;老、少患者,少尿型患者,合并多脏器功能衰竭患者病死率较高;及时透析可降低病死率。
OBJECTIVE: To summarize the etiological characteristics, treatment and prognosis of acute renal failure (ARF) and to discuss the clinical treatment strategies. Methods: A retrospective analysis of 453 cases of ARF clinical data, the use of Logistic regression analysis of various factors and prognosis. Results: ARF caused by medical etiology accounted for 53.6%, followed by surgical reasons accounted for 32.0%, causes of cancer accounted for 9.9%, pediatric and obstetrics and gynecology accounted for a small proportion. The higher the blood urea nitrogen level before dialysis, serum creatinine increased to start dialysis longer, the greater the relative risk of death in patients. The mortality rate of old and less patients was higher than that of young adults (P <0.05). The mortality rates of oliguric and non-oliguric ARF were 50.7% and 15.4% (P <0.01), respectively. No complication and multiple organ function The fatal ARF mortality rates were 28.2% and 78.4%, respectively (P <0.01). CONCLUSIONS: ARF caused by medical etiology ranks the first place, followed by surgical etiology and neoplasm. In older patients, less patients and oliguric patients, patients with multiple organ failure have a higher case-fatality rate; timely dialysis can reduce mortality.