單中心急性腎損傷的臨床特點(diǎn)分析
發(fā)布時(shí)間：2019-02-16 19:13
【摘要】：目的:回顧性分析我院重癥監(jiān)護(hù)室(ICU)患者中急性腎損傷(AKI)的發(fā)生率、危險(xiǎn)因素以及356例AKI漏診患者的漏診率、漏診原因,回顧性分析ICU中AKI患者的臨床特點(diǎn)及危險(xiǎn)因素,提高臨床醫(yī)生對(duì)AKI的認(rèn)識(shí)和診斷水平,從而減少漏診率,降低AKI發(fā)生率,改善患者預(yù)后。方法:以2014年1月和2014年7月我院診斷為AKI的患者以及同時(shí)期全部ICU患者中篩選出的256例AKI患者為研究對(duì)象,分析ICU患者AKI的發(fā)生率、危險(xiǎn)因素和漏診患者的漏診率、漏診原因、醫(yī)生知曉率以及引起AKI漏診的危險(xiǎn)因素。結(jié)果:(1)本中心AKI發(fā)生率為2.80%,男女比例2.1:1,平均年齡(60.35±16.75)歲,AKI漏診率為65.4%,醫(yī)生對(duì)AKI的知曉率為40.9%;ICU患者中AKI發(fā)生率為58.3%,男女比例2.3:1,平均年齡(61.44±16.67)歲。(2)單因素分析提示:腦血管病、其它心臟疾病、多器官功能衰竭、膿毒血癥、惡性腫瘤晚期、β-內(nèi)酰胺類藥物史、解熱鎮(zhèn)痛藥物史是AKI患者漏診的危險(xiǎn)因素;多器官功能衰竭、膿毒血癥、惡性腫瘤晚期、急性呼吸窘迫綜合征、氣管插管呼吸機(jī)治療、休克是ICU患者AKI發(fā)生的危險(xiǎn)因素;(3)logistic逐步回歸模型結(jié)果:腦血管病、惡性腫瘤晚期、多器官功能衰竭、膿毒血癥、β-內(nèi)酰胺類藥物史、解熱鎮(zhèn)痛藥物史是影響AKI患者漏診的獨(dú)立危險(xiǎn)因素;多器官功能衰竭、膿毒血癥、休克為影響ICU患者AKI發(fā)生的獨(dú)立危險(xiǎn)因素,惡性腫瘤晚期為保護(hù)性因素。結(jié)論:(1)腦血管病、多器官功能衰竭、膿毒血癥、解熱鎮(zhèn)痛藥物史是AKI患者漏診的獨(dú)立危險(xiǎn)因素,β-內(nèi)酰胺類藥物史、惡性腫瘤晚期是AKI降低漏診率的保護(hù)性因素;(2)多器官功能衰竭、膿毒血癥、休克為ICU患者中AKI發(fā)生的獨(dú)立危險(xiǎn)因素,惡性腫瘤晚期是影響ICU患者AKI發(fā)生的保護(hù)性因素。
[Abstract]:Objective: to analyze retrospectively the incidence and risk factors of acute renal injury (AKI) in patients with (ICU) in intensive care unit (ICU) of our hospital, and the missed diagnosis rate and cause of missed diagnosis in 356 patients with AKI. The clinical characteristics and risk factors of patients with AKI in ICU were analyzed retrospectively to improve the understanding and diagnosis level of AKI in order to reduce the rate of missed diagnosis, reduce the incidence of AKI and improve the prognosis of the patients. Methods: the incidence of AKI, risk factors and missed diagnosis rate of ICU patients were analyzed by using 256 AKI patients who were diagnosed as AKI in our hospital in January 2014 and July 2014, and among all ICU patients in the same period. Causes of missed diagnosis, doctor awareness and risk factors for missed diagnosis of AKI. Results: (1) the incidence of AKI in our center was 2.80, the ratio of male to female was 2.1: 1, the average age was (60.35 鹵16.75) years old, the rate of missed diagnosis of AKI was 65.4 and the understanding rate of AKI was 40.9. The incidence of AKI in patients with ICU was 58.3%. The ratio of male to female was 2.3: 1, with an average age of (61.44 鹵16.67) years. (2) univariate analysis showed that: cerebrovascular disease, other heart diseases, multiple organ failure, sepsis. The history of 尾-lactams and antipyretic and analgesic drugs were the risk factors of missed diagnosis in patients with AKI in the late stage of malignant tumor. Multiple organ failure, sepsis, advanced malignant tumor, acute respiratory distress syndrome, tracheal intubation ventilator therapy, shock are the risk factors of AKI in ICU patients. (3) the results of logistic stepwise regression model showed that cerebrovascular disease, advanced malignant tumor, multiple organ failure, sepsis, history of 尾 -lactams and antipyretic and analgesic drugs were independent risk factors for missed diagnosis in patients with AKI. Multiple organ failure, sepsis and shock were independent risk factors for AKI in patients with ICU, and advanced malignant tumors were protective factors. Conclusion: (1) the history of cerebrovascular disease, multiple organ failure, sepsis, antipyretic and analgesic drugs are independent risk factors for missed diagnosis in AKI patients. (2) multiple organ failure, sepsis and shock were independent risk factors for the occurrence of AKI in patients with ICU. Advanced malignant tumor was the protective factor affecting the occurrence of AKI in ICU patients.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R692.5
本文編號(hào)：2424752
[Abstract]:Objective: to analyze retrospectively the incidence and risk factors of acute renal injury (AKI) in patients with (ICU) in intensive care unit (ICU) of our hospital, and the missed diagnosis rate and cause of missed diagnosis in 356 patients with AKI. The clinical characteristics and risk factors of patients with AKI in ICU were analyzed retrospectively to improve the understanding and diagnosis level of AKI in order to reduce the rate of missed diagnosis, reduce the incidence of AKI and improve the prognosis of the patients. Methods: the incidence of AKI, risk factors and missed diagnosis rate of ICU patients were analyzed by using 256 AKI patients who were diagnosed as AKI in our hospital in January 2014 and July 2014, and among all ICU patients in the same period. Causes of missed diagnosis, doctor awareness and risk factors for missed diagnosis of AKI. Results: (1) the incidence of AKI in our center was 2.80, the ratio of male to female was 2.1: 1, the average age was (60.35 鹵16.75) years old, the rate of missed diagnosis of AKI was 65.4 and the understanding rate of AKI was 40.9. The incidence of AKI in patients with ICU was 58.3%. The ratio of male to female was 2.3: 1, with an average age of (61.44 鹵16.67) years. (2) univariate analysis showed that: cerebrovascular disease, other heart diseases, multiple organ failure, sepsis. The history of 尾-lactams and antipyretic and analgesic drugs were the risk factors of missed diagnosis in patients with AKI in the late stage of malignant tumor. Multiple organ failure, sepsis, advanced malignant tumor, acute respiratory distress syndrome, tracheal intubation ventilator therapy, shock are the risk factors of AKI in ICU patients. (3) the results of logistic stepwise regression model showed that cerebrovascular disease, advanced malignant tumor, multiple organ failure, sepsis, history of 尾 -lactams and antipyretic and analgesic drugs were independent risk factors for missed diagnosis in patients with AKI. Multiple organ failure, sepsis and shock were independent risk factors for AKI in patients with ICU, and advanced malignant tumors were protective factors. Conclusion: (1) the history of cerebrovascular disease, multiple organ failure, sepsis, antipyretic and analgesic drugs are independent risk factors for missed diagnosis in AKI patients. (2) multiple organ failure, sepsis and shock were independent risk factors for the occurrence of AKI in patients with ICU. Advanced malignant tumor was the protective factor affecting the occurrence of AKI in ICU patients.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R692.5
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