CAJ | 학술논문

目的观察急性肾损伤合并急性消化道出血患者临床特征、发病情况、病因、疾病危险因素及预后.方法回顾性总结分析了山西省人民医院近5年确诊急性肾损伤512例患者,对其消化道出血的临床危险因素、住院病死率及相关独立预测因子进行研究.结果急性肾损伤合并消化道出血53例,上消化道出血45例,临床严重出血15例,消化道出血独立危险因素是心功能衰竭、机械通气、血小板减少、慢性肝病、肝硬化及急性肾损伤3期的患者.伴有消化道出血住院病死率52.8％,不伴有消化道出血患者病死率22.2％.伴有消化道出血病死率明显高于其他患者.结论消化道出血是急性肾损伤常见合并症.而且以上消化道出血更常见.消化道出血与急性肾损伤病死率增加密切相关.肾脏以及肾脏以外其他危险因素与消化道出血发生有关.
목적 관찰급성신손상합병급성소화도출혈환자림상특정、발병정황、병인、질병위험인소급예후.방법 회고성총결분석료산서성인민의원근5년학진급성신손상512례환자,대기소화도출혈적림상위험인소、주원병사솔급상관독립예측인자진행연구.결과 급성신손상합병소화도출혈53례,상소화도출혈45례,림상엄중출혈15례,소화도출혈독립위험인소시심공능쇠갈、궤계통기、혈소판감소、만성간병、간경화급급성신손상3기적환자.반유소화도출혈주원병사솔52.8％,불반유소화도출혈환자병사솔22.2％.반유소화도출혈병사솔명현고우기타환자.결론 소화도출혈시급성신손상상견합병증.이차이상소화도출혈경상견.소화도출혈여급성신손상병사솔증가밀절상관.신장이급신장이외기타위험인소여소화도출혈발생유관.
Objective Few prospective data are currently available on acute gastrointestinal hemorrhage (AGIH) as a complication in acute kidney injury (AKI).The aim of the present study was to find out clinical characteristics,incidence,etiology,risk factors,and outcome of AGIH in patients with AKI.Methods We performed a prospective study on an inceptione cohprt of 512 patients admitted for AKI in our hospital.Data on clinical risk factors for bleeding,frequency of occurrence of AGIH,in-hospital mortality were collected,and independent predictors of AGIH were identified.Results A total of 53 patients had AGIH as a complication of AKI,and 45 were upper AGIH.Fifteen patients had clinically severe bleeding.Independent baseline predictors of AGIH were severity of illness,cardiac failure,mechanical ventilation,low platelet count,chronic hepatic disease,liever cirrhosis,severe AKI.Inhospital mortality was 52.8％ in patients with AGIH,and 22.2％ in the other patients.AGIH was significantly associated with an increase in hospital mortality.Conclusions AGIH are frequent complications of AKI.In this clinical condition,AGIH is more often due to upper gastrointestinal bleeding and is associated with a significantly increased risk of death.Both renal and extrarenal risk factors are related to the occurrence of AGIH.