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1、烧伤介并急性肾功能衰竭的临床研究［摘耍］冃的：探讨烧伤合并急性肾功能衰竭(ARF)的早期指标检测以及各种危险因素和疗效。方法：选择2008年1月、2009年6月所收治的屮重度热烧伤忠者75例，II度或III度烧伤面积累计达20%~70%TBSA。所有患者在入院时、入院后3d、7d、14d和21d检测血清肌酹(Scr)、血尿素氮(BUN)、肌酹清除率(Cct)、24h尿量、尿蛋白、尿微屋白蛋白5ALB)。结果：75例烧伤患者中有14例(18.7%)并发ARF。烧伤合并ARF组平均Ser、Ccr和丿來蛋白水平在住院7d后明显高于烧伤未合并AR
2、I；组(戸均<0.05),平均I3UN水平在住院14d后明显高于烧伤未合并ARF组(P<0.05),平均尿量在住院21d示明显高于烧伤未合并ARE组(P<0.05)o烧伤合并ARF组在入院时mALB水平已达正常值3〜4倍，在观察期均高于烧伤未合并ARF组(P均V0.05)o烧伤面积•脓毒症是烧伤并发ARF的主要危险因素(负相关系数r分别为0.52和0.23,卩均<0.05)。14例ARF患者中冇10例患者行血液净化治疗，具他4例患者给了相应治疗。12例患者痊愈，2例患者(14.3%)分别死于严重脓毒症和多器官功能衰竭。结论：本组资料显示，
3、mALB是早期监测ARF的敏感指标，烧伤合并ARF与烧伤面积与脓毒症相关，连续性静脉-静脉血液滤过(CVVH)治疗烧伤合并ARF疗效较好。［关键词］烧伤；肾功能衰竭；尿微量白蛋白；危险因素［中图分类号］R644［文献标识码］A［文章编号］1673-7210(2011)11(a)-042-03ClinicalstudyofearlyindicatorsofacuterenalfailureinburnedpatientsHEBini,ZHAOBaicheng2,QIANLi2,DAIYonghengl,XIELipingl,HUJial1.
4、ThePeople，sHospitalofNingxiangCounty,HuznanProvinee,Ningxiang410600,China;2.TheSecondHospitalofCentralSouthUniversityofChangshaCity,HurnanProvince,Changsha410011,China［Abstract］Objective:Todeterminethepredictorsofacuterenalfailure(ARF)thatoccurinmajorburns.Methods:Thedata
5、of75patientswithmoderatetoseverethermalburninjuryofsecondtothirddegreewith20%-70%oftotalbodysurfacearea(TBSA)inourhospitalwereanalyzed.Allpatientsweresubjectedtoroutineinvestigationswhichincludedserumcreatinine(Scr),bloodureanitrogen(BUN),creatininoclearancerate(Ccr),24hu
6、rinevolume,totalurinaryprotoin,urinarymicroalbuminuria(mALB)onadmission,3,7,14and21dayslaterofhospitalization.Results:14patients(18.7%)developedARF.ThelevelsofScr,CcrandurirmryproteiningroupwithARFfrom7dayslaterwereobviouslyhigherthanthatingroupwithoutARF(P<0.05).Thelevel
7、sofBuningroupwithARFfrom14dayslaterwereobviouslyhigherthanthatingroupwithoutARF(P〈0・05)・Thelevelsof24hurinevolumeingroupwithARFfrom21dayslaterwereobviouslyhigherthanthatingroupwithoutARF(P<0.05).ThegroupwithARFshowedanincrease1evelofmALBthatreached3-4foldsaboveitsnormalle
8、velonadmissionanditwasobviouslyhigherthanthatingroupwithoutARFintheperiodofobservation(P<0.05)•B
