急性肾衰竭100例临床分析.docxVIP

急性肾衰竭100例临床分析【摘要】目的：探讨急性肾衰竭的病因及临床特点，为早期防治提供理论依据。方法：对我院住院的100例ARF患者进行回顾性分析。分析肾前性、肾实质性和肾后梗阻性ARF的各种病因，并对肾实质性ARF的临床进行重点分析。结果：100例患者中，肾前性ARF20例(20%)病因为胃肠道失液、心衰、肾病综合征、术后缺血等。肾实质性ARF 70例(70%，)其中42例(42%)肾实质性ARF是由明确的肾前性因素发展而来。肾后梗阻性ARF10例(10%)，病因为肿瘤、结石、前列腺增生、腹膜后纤维化、泌尿系畸形、神经性膀胱。结论：肾前性ARF常被忽视，未能及时诊断;肾小管间质病变是肾实质性ARF主要原因，药物是首位病因。　　【关键词】肾衰竭；肾小管间质病变；肾小球血管病变　　　　100 cases of acute renal failure analysis　　PENG Pei LI Xinhua　　 【Abstract】Objective: To investigate the cause of acute renal failure and the clinical features, for the prevention and treatment of early and provide a theoretical basis. Methods: The hospitals 100 patients hospitalized patients with ARF reviewed. Analysis of renal ago, after the kidney and renal substantive obstruction of the various causes of ARF, ARF and kidney substantive analysis of a key. Results: 100 patients, before the kidney of ARF20 cases (20%) of gastrointestinal disease because of loss, heart failure, nephrotic syndrome, such as after ischemia. Substantive ARF 70 kidney patients (70 percent) of which 42 cases (42%) renal substantive ARF is clear from the kidney developed from the former factor. After the obstruction of ARF10 renal patients (10 percent), because of cancer, stones, prostate hyperplasia, retroperitoneal fibrosis, urinary tract malformations, neurological bladder. Conclusion: The kidney of the ARF are often ignored before, failed to timely diagnosis; tubulointerstitial substantive ARF kidney disease is the main reason is the first drug causes. 　　【Key words】 Renal failure; Tubulointerstitial lesions; Glomerular disease　　　　 急性肾衰竭(ARF)是由多种病因引起的临床综合征，表现为肾功能在数小时至数周内急剧恶化，体内代谢产物潴溜，水电解质及酸碱平衡紊乱。我们对我院2003年1月~2007年1月资料齐全的100例ARF的临床资料进行了回顾性分析研究。　　　　1 研究对象与方法　　　　1.1 研究对象和诊断标准。2003年1月~2007年1月我院住院的ARF患者。ARF诊断标准为：①原肾功能正常者，短期内血肌酐SCr))2mg/dl(≥176.8umo/l）[1]和(或)肌醉清除率下降≥50%[3];②原有慢性肾衰竭者，短期内SCr较前升高50%和(或)肌配清除率下降15%。③-SCr每天上升≥0.5mg/dl。　　1.2 ARF的分类：ARF按病变部位不同分为肾前性、肾实质性和肾后梗阻性。肾实质性ARF又分为肾小管间质病变，肾小球血管病变。同时寻找原发病因和继发因素。　　1.2.1 肾前性ARF：根据全身情况如口干、皮肤皱褶、药物使用情况、血压、