中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2014年
10期
1855-1858
,共4页
烧伤%肾功能衰竭%补液疗法%胱抑素C
燒傷%腎功能衰竭%補液療法%胱抑素C
소상%신공능쇠갈%보액요법%광억소C
Burns%Kidney failure%Fluid therapy%Cystatin C
目的：探讨特重度烧伤并发急性肾功能衰竭（acute renal failure，ARF）的相关因素，为临床早期防治ARF提供依据。方法分析我科2003年1月至2012年12月收治的特重度烧伤362例烧伤后开始接受液体复苏治疗的时间和方法，并结合测定的生化指标，分析特重度烧伤与ARF的相关性。结果362例特重度烧伤中有27例并发ARF，烧伤面积＞90%组ARF发生比例明显高于其他各组（P＜0.05）。烧伤面积＞70%组，伤后2 h以后开始接受液体复苏治疗组发生ARF明显高于伤后2 h以内开始治疗组（P＜0.05）。发生ARF者，血尿素氮（BUN）在伤后14 d明显高于无ARF者（P＜0.05），血肌酐（Scr）在伤后7 d明显高于无ARF者（P＜0.05），胱抑素C（CysC）在伤后2 d明显高于无ARF者（P＜0.05）。结论烧伤面积和伤后液体复苏开始治疗时间均与烧伤并发ARF呈正相关，发生ARF时患者BUN、Scr、CysC均明显升高，CysC测定可能成为早期检测ARF的敏感指标。
目的：探討特重度燒傷併髮急性腎功能衰竭（acute renal failure，ARF）的相關因素，為臨床早期防治ARF提供依據。方法分析我科2003年1月至2012年12月收治的特重度燒傷362例燒傷後開始接受液體複囌治療的時間和方法，併結閤測定的生化指標，分析特重度燒傷與ARF的相關性。結果362例特重度燒傷中有27例併髮ARF，燒傷麵積＞90%組ARF髮生比例明顯高于其他各組（P＜0.05）。燒傷麵積＞70%組，傷後2 h以後開始接受液體複囌治療組髮生ARF明顯高于傷後2 h以內開始治療組（P＜0.05）。髮生ARF者，血尿素氮（BUN）在傷後14 d明顯高于無ARF者（P＜0.05），血肌酐（Scr）在傷後7 d明顯高于無ARF者（P＜0.05），胱抑素C（CysC）在傷後2 d明顯高于無ARF者（P＜0.05）。結論燒傷麵積和傷後液體複囌開始治療時間均與燒傷併髮ARF呈正相關，髮生ARF時患者BUN、Scr、CysC均明顯升高，CysC測定可能成為早期檢測ARF的敏感指標。
목적：탐토특중도소상병발급성신공능쇠갈（acute renal failure，ARF）적상관인소，위림상조기방치ARF제공의거。방법분석아과2003년1월지2012년12월수치적특중도소상362례소상후개시접수액체복소치료적시간화방법，병결합측정적생화지표，분석특중도소상여ARF적상관성。결과362례특중도소상중유27례병발ARF，소상면적＞90%조ARF발생비례명현고우기타각조（P＜0.05）。소상면적＞70%조，상후2 h이후개시접수액체복소치료조발생ARF명현고우상후2 h이내개시치료조（P＜0.05）。발생ARF자，혈뇨소담（BUN）재상후14 d명현고우무ARF자（P＜0.05），혈기항（Scr）재상후7 d명현고우무ARF자（P＜0.05），광억소C（CysC）재상후2 d명현고우무ARF자（P＜0.05）。결론소상면적화상후액체복소개시치료시간균여소상병발ARF정정상관，발생ARF시환자BUN、Scr、CysC균명현승고，CysC측정가능성위조기검측ARF적민감지표。
Objective Through investigation the related factors of acute renal failure(ARF) with severely thermal burn, and provide evidence for clinical early prevention and treatment of ARF. Methods 362 cases data with ARF admitted into our department during January 2003 to December 2012 with severely thermal burn were enrolled to analyze the time and method began to receive fluid resuscitation therapy, combined with their biochemical index determination, to analyze the correlation of severely thermal burn with ARF. Results In 362 cases of severely thermal burn patients were 27 cases complicated with ARF, and the ARF incidence of burn area more than 90%was significantly higher than the other groups (P<0.05). In burn area more than 70%group, the ARF incidence of 2 hours after injury began to accept fluid resuscitation group was significantly higher than within 2 hours after injury to the treatment group (P<0.05). In 27 cases of ARF, blood urea nitrogen index (BUN) at 14 days after injury, serum creatinine (Scr) index in 7 days after injury, Cystatin C (CysC) index in 2 days after injury were significantly higher than those without ARF(P<0.05). Conclusion Burn area and wound fluid resuscitation began treatment time were positively correlated with burn complicated with ARF, and with the occurrence of ARF the index of BUN, Scr, CysC were significantly increased, so CysC determination may be sensitive markers for early detection of ARF.
