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目的:探讨新生儿急性肾功能衰竭(ARF)的临床特点。方法:回顾性分析2007年1月～2009年12月在南京医科大学附属南京儿童医院NICU中收治的13例ARF的新生儿的临床特点、实验室检查、治疗及预后。结果:新生儿急性肾功能衰竭的发病率为2.2‰;发病原因:败血症8例(61.5%)、新生儿窒息3例(23.1%)、泌尿系畸形2例(15.4%)。临床表现不典型,少尿者多见,而高血压、浮肿、肉眼血尿少见。治疗为综合性治疗,13例患者中12例中途放弃治疗,但其中5例出院时肾功能已经恢复正常,1例治愈出院。平均住院时间5.38天。结论:新生儿败血症和新生儿窒息是NICU中ARF的发病主要原因。加强尿量和肾功能受损早期的指标监测有助于早期诊断。综合治疗,减轻肾负荷,保护残存肾单位的功能,有助于改善预后。
Objective: To investigate the clinical features of neonatal acute renal failure (ARF). Methods: The clinical features, laboratory examination, treatment and prognosis of 13 neonates with ARF admitted to Nanjing Children’s Hospital Affiliated to Nanjing Medical University from January 2007 to December 2009 were retrospectively analyzed. Results: The incidence of neonatal acute renal failure was 2.2 ‰. The causes of the disease were: septicemia in 8 cases (61.5%), neonatal asphyxia in 3 cases (23.1%) and urinary malformation in 2 cases (15.4%). Clinical manifestations of atypical oliguria more common, and high blood pressure, edema, rare gross hematuria. Treatment for comprehensive treatment, 13 patients in 12 cases give up treatment, but 5 of them discharged at the time of renal function has returned to normal, 1 patient was discharged. The average hospital stay was 5.38 days. Conclusion: Neonatal sepsis and neonatal asphyxia are the main causes of ARF in NICU. Strengthen the early detection of indicators of urine output and impaired renal function can help early diagnosis. Comprehensive treatment, reduce renal load, protect the function of residual nephrons, help to improve the prognosis.