地震伤挤压综合征急性肾衰竭治疗探讨
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摘要
目的探讨地震伤后挤压综合征急性肾衰竭治疗。方法回顾性分析5.12地震伤后23例挤压综合征急性肾衰竭患者的临床资料。结果23例患者中,1例因并发急性肺水肿死亡,17例高钾血症纠正,3例进入多尿期,肾功能改善;其余19例病情得以控制,22例存活者病情稳定后转移至外地医院。结论血液透析及全身营养支持等综合治疗,可有效改善挤压综合征急性肾衰竭患者的病情,安全渡过少尿期。
Objective To explore the treatment of crush syndrome complicating acute renal failure after earthquake injury. Methods A retrospective analysis was made on 23 clinical cases of crush syndrome complicating acute renal failure after 5.12 earthquake injury. Results Of 23 cases,1 died of acute pneumochysis; 17 hyperkalemia were rectified; 3 evolved diuresis stage following improved renal function; and clinical symptoms were improved in the other 19. 22 cases were conveied to many hospitals in other provinces after 7～10 days in our hospital. Conclusion It was effective that combined therapy (conventional hemodialysis, continuous renal replacement therapy and others)to treat crush syndrome complicating acute renal failure , and to assist patients overshoot oliguria stage.
Objective To explore the treatment of crush syndrome complicating acute renal failure after earthquake injury. Methods A retrospective analysis was made on 23 clinical cases of crush syndrome complicating acute renal failure after 5.12 earthquake injury. Results Of 23 cases,1 died of acute pneumochysis; 17 hyperkalemia were rectified; 3 evolved diuresis stage following improved renal function; and clinical symptoms were improved in the other 19. 22 cases were conveied to many hospitals in other provinces after 7～10 days in our hospital. Conclusion It was effective that combined therapy (conventional hemodialysis, continuous renal replacement therapy and others)to treat crush syndrome complicating acute renal failure , and to assist patients overshoot oliguria stage.
引文
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[2]Gunal AI,Celikeer H,Dogukan A,et al.Early and vigorous fluid resuscitation prevents acute renal failure in the crush victims of catastrophic earthquakes[J].J Am Soc Nephrol,2004,15:1862-1867.
[3]方国思,赵为国.挤压综合征和肾功能不全[J].中国实用外科杂志,2002,22:70-72.
[4]Lauer A,Alvis R,Avram M.Hemodynamic consequences of continuous arteriovenous hemofiltration[J].Am J Kidney Dis,1988,12:110-115.
[5]王质刚.连续性肾脏替代疗法的进展及其临床应用[J].肾脏病与透析肾移植杂志,1998,7:478.
[2]Gunal AI,Celikeer H,Dogukan A,et al.Early and vigorous fluid resuscitation prevents acute renal failure in the crush victims of catastrophic earthquakes[J].J Am Soc Nephrol,2004,15:1862-1867.
[3]方国思,赵为国.挤压综合征和肾功能不全[J].中国实用外科杂志,2002,22:70-72.
[4]Lauer A,Alvis R,Avram M.Hemodynamic consequences of continuous arteriovenous hemofiltration[J].Am J Kidney Dis,1988,12:110-115.
[5]王质刚.连续性肾脏替代疗法的进展及其临床应用[J].肾脏病与透析肾移植杂志,1998,7:478.
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