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目的研究脑出血并发急性肾功能损害病人病死率及其发生原因。方法收集 196例脑出血病人 ,其中 92例并发急性肾功能损害者作为A组 ,与 10 4例无肾损害者作为B组进行对照。结果A组死亡 36例 ,病死率 39 1% ;B组死亡 8例 ,病死率 7 6 9% ,二者差异有显著意义 (x2 =2 7 5 6 5 ,P <0 0 1)。具有糖尿病病史者百分比 ,A组明显高于B组 (P <0 0 1)。丘脑出血发生率 ,A组明显高于B组 (0 0 5 >P >0 0 1)。出血量 ,A组明显大于B组 (0 0 5 >P >0 0 1)。液体入量 ,每日 15 0 0 ± ml者百分比 ,A组明显高于B组 (P <0 0 1)。 2 0 %甘露醇静滴 ,每日 2 5 0ml 3～ 4次者百分比 ,A组明显高于B组 (P <0 0 1)。结论脑出血并发急性肾功能损害者 ,其病死率明显高于对照组 ,而其发生原因与糖尿病、脑出血量、丘脑出血、液体入量不足及甘露醇使用量大等因素相关。
Objective To study the case fatality rate and the causes of acute renal dysfunction in patients with cerebral hemorrhage. Methods A total of 196 patients with cerebral hemorrhage were collected, 92 of them with acute renal impairment were selected as group A and 104 as controls without renal impairment. Results There were 36 deaths in group A with a mortality rate of 39 1%. There were 8 deaths in group B with a mortality rate of 76.9%. There was significant difference between the two groups (χ2 = 276565, P <0.01). The percentage of patients with a history of diabetes was significantly higher in group A than in group B (P <0.01). The incidence of thalamic hemorrhage in group A was significantly higher than that in group B (0 0 5> P 0 01). The amount of bleeding in group A was significantly greater than that in group B (0 0 5> P 0 01). Fluid volume, the daily percentage of 15 ± 0 ± ml, A group was significantly higher than the B group (P <0 0 1). 20% mannitol intravenous infusion of 250 ml daily for 3 to 4 times, the percentage of group A was significantly higher than that of group B (P <0.01). Conclusions The mortality of patients with cerebral hemorrhage complicated by acute renal dysfunction is significantly higher than that of the control group. The causes of cerebral hemorrhage are related to the factors such as diabetes mellitus, cerebral hemorrhage, hypothalamic hemorrhage, insufficient fluid intake and mannitol consumption.