本文選題：急性腎損傷　切入點：病因　出處：《廣西醫(yī)科大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:探討上尿路梗阻致急性腎損傷的病因以及分析影響腎功能恢復的相關性因素,為臨床更好地預防急性腎損傷、改善患者的預后提供依據(jù)。方法:回顧性分析2012年1月至2016年12月期間在廣西醫(yī)科大學第一附屬醫(yī)院泌尿外科住院治療的患者的臨床資料,按照納入與排除標準,篩選出病史完整的118例AKI患者,記錄患者基本情況、相關檢查、治療方式、預后等臨床資料。以患者術后1月作為截止點,根據(jù)AKI患者腎功能恢復情況,將AKI患者預后分為腎臟治愈組,部分愈合組及愈合不良組組三組。用SPSS16.0統(tǒng)計學軟件統(tǒng)計分析AKI患者預后的獨立危險因素。運用了χ2檢驗、獨立樣本t檢驗、單因素方差分析以及多元Logistic回歸分析統(tǒng)計分析方法。結果:觀察118例上尿路梗阻致急性腎損傷的病因中,上尿路結石是最常見的病因,占88.14%,腫瘤轉移或者壓迫,占7.63%,其他導致急性腎損傷占4.24%,比如輸尿管炎性狹窄、移植腎輸尿管下端狹窄并積水等。其中上尿路結石所致急性腎損傷患者的病因中,孤立腎輸尿管結石占52.88%(55/104);雙側輸尿管結石占34.62%(36/104);單側輸尿管結石合并另一側腎結石4.8%(5/104);一側輸尿管結石7.69%(8/104)。獨立樣本t檢驗分析腎功能恢復與患者年齡、血鉀濃度(K+)、血紅蛋白(Hb)等一般臨床資料無關,單因素卡方檢驗分析提示術后是否出現(xiàn)多尿期、AKI分期以及RRT與腎臟預后差異有統(tǒng)計學意義,但經(jīng)多因素校正后僅臨床分期以及RRT腎臟預后差異有統(tǒng)計學意義。結論:本組資料中急性腎損傷的主要病因為上尿路結石、其次為腫瘤;AKI臨床分期為急性腎損傷患者預后不良的危險因素,RRT是上尿路梗阻性急性腎損傷的保護因素。
[Abstract]:Objective: to investigate the etiology of acute renal injury caused by upper urinary tract obstruction and to analyze the related factors affecting the recovery of renal function in order to prevent acute renal injury in clinic. Methods: the clinical data of patients hospitalized in Urology Department of the first affiliated Hospital of Guangxi Medical University from January 2012 to December 2016 were analyzed retrospectively. A total of 118 patients with AKI with complete history were selected to record the basic information, relevant examinations, treatment methods, prognosis and other clinical data. Taking January as the cut-off point, according to the recovery of renal function in patients with AKI, The prognosis of AKI patients was divided into three groups: kidney healing group, partial healing group and poor healing group. The independent risk factors of prognosis of AKI patients were statistically analyzed by SPSS16.0 statistical software. 蠂 2 test and independent sample t test were used. Results: among 118 cases of acute renal injury caused by upper urinary tract obstruction, upper urinary tract stone was the most common cause, accounting for 88.14%, tumor metastasis or compression. Other causes of acute renal injury, such as ureteral inflammatory stenosis, renal graft ureteral stenosis and hydronephrosis, were among the causes of acute renal injury caused by upper urinary calculi. Isolated renal ureterolithiasis accounted for 52.88 / 104%; bilateral ureteral calculi accounted for 34.62% 36 / 104%; unilateral ureterolithiasis combined with another side of renal calculi 4.8 / 104; side ureteral stones 7.69% / 104; independent sample t test analysis of renal function recovery and patient age. There was no significant difference in clinical data, such as serum potassium concentration and hemoglobin (HB). Univariate chi-square test showed that there were significant differences in the stage of polyuria and the prognosis between RRT and kidney. But only clinical stage and renal prognosis of RRT were significantly different after multivariate correction. Conclusion: the main cause of acute renal injury in this group is upper urinary calculi. The clinical stage of AKI was the risk factor of poor prognosis in patients with acute renal injury. RRT was the protective factor of acute renal injury caused by upper urinary tract obstruction.
【學位授予單位】：廣西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R692

【參考文獻】

相關期刊論文 前10條

1 桂志明;蘇勁;柳健軍;吳宏;黃興端;許志堅;黃木春;;輸尿管軟鏡鈥激光碎石術與經(jīng)皮腎鏡取石術治療輸尿管上段大結石的療效比較[J];臨床泌尿外科雜志;2017年01期

2 賈燕華;陳平;;輸尿管鏡鈥激光碎石術治療輸尿管結石臨床療效[J];疾病監(jiān)測與控制;2017年01期

3 楊其順;張琳;姜偉;;輸尿管鏡治療急性上尿路梗阻性腎功能衰竭臨床研究[J];臨床軍醫(yī)雜志;2016年12期

4 王鈞鈞;;上段輸尿管結石3種微創(chuàng)治療方法的對比分析[J];中國醫(yī)藥指南;2016年31期

5 孫宏偉;郭濤;許加剛;王化明;韓明宏;張煥杰;;體外沖擊波碎石術對不同病程輸尿管結石患者的治療效果[J];河南醫(yī)學研究;2016年11期

6 高潮;;微創(chuàng)經(jīng)皮輸尿管鏡在嵌頓性輸尿管上段結石治療中的臨床應用效果分析[J];中國臨床新醫(yī)學;2016年09期

7 李壯志;;不同微創(chuàng)取石術式治療復雜性輸尿管上段結石近遠期療效、安全性及經(jīng)濟性比較[J];微創(chuàng)泌尿外科雜志;2016年04期

8 王建忠;周駿;施浩強;邰勝;楊誠;汪越;梁朝朝;;達芬奇機器人腹腔鏡技術在泌尿外科手術中的應用[J];安徽醫(yī)學;2016年06期

9 董文霞;俞婭芬;彭俊瓊;錢鑫峰;儲臘萍;周麗芳;;住院腫瘤患者急性腎損傷的發(fā)病及預后相關危險因素分析[J];中國中西醫(yī)結合腎病雜志;2016年02期

10 段瑞華;梅力;張毅;;輸尿管軟鏡鈥激光碎石術與經(jīng)皮腎鏡鈥激光碎石術治療輸尿管上段結石的療效比較[J];臨床合理用藥雜志;2016年04期

相關會議論文 前1條

1 方藝;丁小強;鐘一紅;鄒建洲;湯穎;林靜;林攀;俞小芳;;住院患者急性腎損傷的發(fā)病情況調查[A];2007年浙滬兩地腎臟病學術年會資料匯編[C];2007年

相關碩士學位論文 前3條

1 翁金山;住院患者急性腎損傷的流行病學調查[D];福建醫(yī)科大學;2013年

2 郎勝坤;上尿路梗阻的影像學評價和臨床對比應用研究[D];河北醫(yī)科大學;2011年

3 張洪濤;經(jīng)輸尿管鏡治療輸尿管結石所致急性梗阻性腎功能衰竭的療效[D];新疆醫(yī)科大學;2009年

，

本文編號：1617962