软组织损伤患者中急性肾损伤的发生情况及危险因素分析

发布时间：2018-10-09 10:00

【摘要】：目的：了解多发软组织损伤患者中急性肾损伤(AKI)的发生情况,筛选与AKI发生相关的临床危险因素。方法：选择2008年1月1日至2013年1月1日期间于新疆医科大学第一附属医院的513例诊断为多发软组织损伤且资料完整的住院患者。回顾性收集患者的人口统计学资料、损伤发生前后的临床资料和实验室检查结果。分析患者多发软组织损伤后AKI发生相关的独立危险因素。结果：共513例患者入选,平均年龄(31.30±15.62)岁,男女比例为2.11：1。74例发生AKI,发生率为14.42%。殴打伤患者中无AKI发生,车祸伤患者中发生AKI为27例(36.5%),其他原因损伤4例(5.4%)。损伤面积1%患者中发生AKI为1例(1.36%),损伤面积1%～3%的患者中发生AKI为4例(5.4%),损伤面积3%-5%的患者中发生AKI为10例(13.6),损伤面积5%的患者中发生AKI为19例(25.7%),且各组差异有统计学意义(p0.01)。伴有慢性肾病患者AKI的发生率显著高于不伴有慢性肾病的患者(54.5%比20.3%,P0.01)。74例AKI患者中死亡2例,病死率2.7%。多因素Logistic回归分析示：年龄(OR=1.996)、基础Scr(OR=0.976)、基础eGFR (OR=0.964)、血K+(OR=2.117)、肌红蛋白(OR=0.950)、损伤面积(OR=1.811)是多发软组织损伤患者发生AKI的独立危险因素。结论：多发软组织损伤患者中AKI的发病率较高。年龄、基础Scr、基础eGFR、血K+、肌红蛋白、损伤面积是多发软组织损伤患者发生AKI的独立危险因素。
[Abstract]:Objective: to investigate the incidence of acute renal injury (AKI) in patients with multiple soft tissue injuries and to screen the clinical risk factors associated with AKI. Methods: from January 1, 2008 to January 1, 2013, 513 inpatients with multiple soft tissue injuries and complete data were selected from the first affiliated Hospital of Xinjiang Medical University. The demographic data, clinical data and laboratory findings before and after injury were collected retrospectively. To analyze the independent risk factors of AKI after multiple soft tissue injury. Results: a total of 513 patients were enrolled with an average age of (31.30 卤15.62) years. The incidence of AKI, was 14.42% in 2.11: 1.74 cases. AKI was found in 27 cases (36.5%) and other causes in 4 cases (5.4%). AKI was found in 1 case (1.36%), AKI in 4 cases (5.4%), AKI in 10 cases (13.6%) and AKI in 19 cases (25.7%) among the patients with injury area of 1% (1.36%), and the difference was statistically significant (p0.01). The incidence of AKI in patients with chronic nephropathy was significantly higher than that in patients without chronic nephropathy (54.5% vs 20.3%, P0.01). Multivariate Logistic regression analysis showed that age (OR=1.996), basic Scr (OR=0.976), basic eGFR (OR=0.964), blood K (OR=2.117), myoglobin (OR=0.950) and injury area (OR=1.811) were independent risk factors for AKI in patients with multiple soft tissue injuries. Conclusion: the incidence of AKI in patients with multiple soft tissue injury is higher. Age, basal eGFR, blood K, myoglobin and injury area were independent risk factors for AKI in patients with multiple soft tissue injuries.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R692.5

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