中国血液净化

›› 2005, Vol. 4 ›› Issue (9): 479-483.

• 论著 • 上一篇    下一篇

57例老年人急性肾衰竭的临床特点

李 洁 汪年松
  

  1. 200233 上海，交通大学附属第六人民医院肾内科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2005-09-12 发布日期:2005-09-12

  • Received:1900-01-01 Revised:1900-01-01 Online:2005-09-12 Published:2005-09-12

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摘要： 目的 探讨老年人发生ARF的病因、预后及其相关因素。方法 收集上海交通大学附属第六人民医院2003年12月～2004年12月期间所有住院ARF患者共96例，按年龄分为老年组（≥60岁）和对照组（＜60岁）。对比分析两组患者的临床资料、治疗和预后。结果 老年组ARF患者为57例（59.4%），青年组ARF患者为39例（40.6%）老年组的主要病因为严重感染、肾后梗阻；与青年组相比老年合并症以呼吸系统、心血管系统、感染为多见（P均＜0.05），且原有糖尿病（P＜0.05）、肾功能不全史、少尿史、心力衰竭、呼吸衰竭、机械通气以及需要透析治疗的比例高于对照组；老年组病死率为38.6%，死因主要为原发病伴MODS，与对照组无差异（ P＞0.05）。结论 老年患者ARF发生率高，感染为主要的病因，也是主要的并发症以及死亡原因，原有基础疾病发生率高，易出现MODS，治疗难度大。年龄与预后无关。

关键词: 老年人, 急性肾衰竭, 病因

Abstract: Objectives To investigate the etiology prognosis and the risk factors of the acute renal failure(ARF) in the elderly patients. Methods All 96 patients with ARF in our hospital from Dec 2003 to Dec 2004 were divided into two groups: senile group (≥60 years old) and control group (＜60 years old). The clinical features, treatments and outcomes were analyzed. Results The senile group had 57patients（59.4%）;control group had 39 patients（40.6%）; the main causes of ARF in the elderly was severe infection and post renal obstructive diseases. The main complications were as follows: cardiovascular diseases, respiratory disease and severe infections. The diabetes mellitus（P＜0.05）, chronic renal failure, oliguria, respiratory failure, heart failure, mechanical ventilation, the need of renal replacement therapy were more prevalent in elderly patients than that in the younger ARF patients. The mortality of elderly patients was 38.6%, and the main cause of the death was the primary disease complicated with multiple organ dysfunction syndrome MODS, just as the control group(P＞0.05). Conclusions Severe infection was the main cause of ARF, complications and death in elderly ARF patients. The primary diseases, severe complications and MODS were more prevalent in elderly patients. There is no difference of prognesis between senile group and control group.

Key words: Acute renal failure, Etiology

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