妊娠期急性肾损伤的预后:来自三级医院的观察和前瞻性研究

Priyadarshi Mandal, Sucheta Biswas, Debasish Char, Mrittika Roy, Sangeeta Chhaya
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摘要

目的探讨妊娠相关性急性肾损伤(PRAKI)在产科的处理及预后。这项观察性和前瞻性研究在一所三级医学院和医院进行了为期一年的9270例分娩,其中包括79例妊娠期AKI病例。我们的研究包括所有在门诊和急诊就诊的孕妇和产后妇女,包括预约和未预约的病例。记录了所有调查、管理和结果的详细分析。AKI的诊断标准包括:(a)突发性少尿(24hrs尿量1.5mg/dl)。在本研究中,入院时或诊断时的肌酐值在1.5至18.2 mg/dl之间,平均值为4.53±3.24 mg/dl。大多数(51.9%)患者的血压值低于4 mg/dl。79例患者中,38例患者需要血液透析,占48.1%。大多数败血症患者(32例中有17例)需要血液透析。本研究中AKI的病死率为16.46%。脓毒症是导致产妇死亡的主要原因,在本研究中占15.6%。59例出院时病情稳定,占74.68%。
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An outcome of acute kidney injury during pregnancy: An observation and prospective study from tertiary care hospital
To study the management and outcome of Pregnancy-related Acute Kidney Injury (PRAKI) in obstetrics. This observational and prospective study was conducted in 9270 deliveries including 79 cases of AKI in pregnancy at a tertiary medical college and hospital for the duration of one year. All pregnant and postpartum women attending out patient department (OPD) and emergency as booked and unbooked cases were included in our study. A detailed analysis of all investigations, management and outcome were recorded. Diagnostic criteria of AKI include (a) sudden in onset oliguria (24hrs urine output <400 ml) or anuria (b) serum creatinine level >1.5mg/dl. In the present study the creatinine values during admission or during diagnosis ranged between 1.5 to 18.2 mg/dl with a mean of 4.53±3.24 mg/dl. Majority (51.9%) of the patients have values less than 4 mg/dl. Out of 79 cases, 38 patients required hemodialysis that comes up to 48.1%. Most of the sepsis patients (17 out of 32) required hemodialysis. Case fatality rate due to AKI was 16.46% in our study. Sepsis was responsible for more maternal death, 15.6% in this study. Total 59 patients (74.68%) were discharged in stable conditions.
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