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目的回顾性分析血液透析在治疗老年急性肾功能衰竭(ARF)的应用和影响预后的因素。方法1992年2月至2007年2月使用血液透析治疗老年ARF 181例,回顾性分析患者的临床特点,血液透析方法和预后。结果181例患者中119例(65.75%),渡过ARF急性期,其中治愈108例(59.67%),11例(6.08%)转变为慢性肾功能衰竭(CRF),62例(34.25%)死亡,对两组患者肾功能的特点,疾病的严重程度(APACHEⅡ)等因素分析,死亡组年龄更大、病情更严重、透前血清肌酐(Scr)更高。每日或隔日血液透析,平均每天尿素氮(BUN)、Scr、超滤量、低血压发生率、精神状态,同经验性的透析组比较,有统计学的意义。结论血液透析是治疗老年ARF最有效的方法。老年ARF的预后受患者的年龄、透前Scr、病情严重程度合并多器官功能不全综合征(MODS)等因素的影响,每日血液透析更适应于老年ARF的治疗。
Objective To retrospectively analyze the application of hemodialysis in the treatment of senile acute renal failure (ARF) and its prognostic factors. Methods A total of 181 elderly ARF patients were treated with hemodialysis from February 1992 to February 2007, and the clinical features, hemodialysis methods and prognosis were retrospectively analyzed. Results A total of 119 patients (65.75%) of 181 patients crossed the acute stage of ARF, 108 (59.67%) were cured, 11 (6.08%) were converted to chronic renal failure (CRF) and 62 The characteristics of renal function, severity of disease (APACHEⅡ) and other factors in the two groups of patients were analyzed. The age of death group was older and the condition was more serious. The serum creatinine (Scr) before the breakthrough was higher. Daily or every other day hemodialysis, the average daily urea nitrogen (BUN), Scr, ultrafiltration volume, the incidence of hypotension, mental status, compared with the experimental dialysis group, statistically significant. Conclusion Hemodialysis is the most effective method for the treatment of ARF in the elderly. The prognosis of elderly patients with ARF by the age, pre-Scr, the severity of the merger of multiple organ dysfunction syndrome (MODS) and other factors, daily hemodialysis more adapted to the treatment of elderly ARF.