目的 探讨近5年本院出生48小时内急性肾衰竭(acute renal failure,ARF)新生儿的临床特征.方法 回顾性分析2012年1月至2016年12月于本院新生儿重症监护病房(newborn intensive care unit,NICU)收治的出生48小时内7682例新生儿中33例ARF患儿的临床资料,并分析其临床特点.结果 出生48小时内新生儿ARF发病率为4.30‰(33/7682),实验室检查指标和B超均提示异常,主要发病原因为:新生儿败血症10例(30.30%),早产、极低出生体重儿8例(24.24%),泌尿系统发育异常6例(18.18%),新生儿窒息4例(12.12%),先天性肾病综合征2例(6.06%),脱水1例(3.03%),主动脉弓离断1例(3.03%),先天性梅毒1例(3.03%).临床表现病情重,进展快,少尿者多见,而高血压、浮肿、肉眼血尿少见.33例患儿死亡8例(24.24%),24例患儿肾功能明显恢复.结论 败血症和早产儿是近5年本院NICU收治的出生48小时内新生儿ARF的主要发病原因,病情重,进展快,死亡率高,综合治疗联合连续性肾脏替代治疗可改善患儿预后.%Objective To investigate the clinical characteristics of acute renal failure (ARF) neonate born within 48 hours in our hospital within 5 years.Method The clinical data of 33 neonates diagnosed with ARF in 7682 neonates from January 2012 to December 2016 were analyzed, and explored its clinical characteristics. Result The neonatal ARF within 48 hours incidence rate was 4.30‰ (33/7682). The laboratory test indicators and B ultrasound were abnormal. The main cause of the disease: 10 cases (30.30%) with sepsis, 8 cases (24.24%) with premature infant/low birth weight infants, 6 cases (18.18%) with urinary dysplasia, 4 cases (12.12%) with neonatal asphyxia, 2 cases (6.06%) with congenital nephrotic syndrome, 1 case (3.01%) with dehydration, 1case (3.01%) with interrupted aortic arch, 1 case (3.01%) with congenital syphilis. Clinical manifestations of serious illness, rapid progress, oliguria were more common, and high blood pressure, edema, naked eye hematuria were rare. Among 33 cases of neonatal, 8 cases (24.24%) died, renal function of 24 cases were restored.Conclusion Sepsis and premature infant are the main causes of ARF neonate born within 48 hours at NICU in our hospital in recent 5 years. The disease is serious, with rapid progress and high mortality. Comprehensive treatment and continuous renal replacement therapy can improve the prognosis.
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