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Incidence and risk fators of hospital-acquired acute liver injury in ICU
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摘要:
目的探讨医院获得性急性肝脏损伤（HA-ALI）在ICU中的发病情况和易患因素,并分析影响HA-ALI患者预后的高危因素。方法对综合性ICU收治的患者入院时肝功能正常,在住院期间出现急性肝损伤（ALI）的127例重症患者临床资料进行回顾性分析。结果 ICU中HA-ALI发病率为7.83%,药物、胃肠外营养、机械通气等是常见的易患因素;死亡组患者年龄较大（P<0.01）,血清白蛋白较低（P<0.01）;心肺复苏、休克和镇静与麻醉药物的使用,为独立危险因素。结论重症患者HA-ALI发生率较高,一些治疗措施有可能引起或加重ALI,患者的年龄、肝功能状况和休克等因素对患者的预后产生较大的影响。
Abstract:Objective To investigate the incidence and risk factors of the hospital-acquired acute liver injury(HA-ALI) in ICU and analyze the impact of high risk factors on the prognosis of patients with HA-ALI. Methods 127 critically ill patients in general ICU were chosen, who had normal liver function on admission but progressed to acute liver injury (ALI) during hospitalization. All clinical data were analyzed retrospectively. Results Incidence rate of HA-ALI in ICU was 7.83%. Drugs, parenteral nutrition, mechanical ventilation and so on, were the common risk factors. The age was older and serum albumin level was lower in the death group (all P<0.01). Cardiopulmonary resuscitation, shock, and the use of sedatives and narcotic drugs were regarded as the independent risk factors. Conclusion The incidence of HA-ALI was higher in critically ill patients. Some therapeutic measures maybe induce or aggravate ALI. Age, status of liver function ,shock etc, can obviously affect the prognosis of the patients with HA-ALI.
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Key words:
- liver diseases /
- iatrogenic disease
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