地震伤挤压综合征患者治疗进程中尿量与肾脏血流阻力指数的相关性研究
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摘要
目的:探讨挤压综合征患者治疗进程中尿量变化与肾脏血流阻力指数改变的相关性及其意义。方法:监测9例地震伤挤压综合征患者在以连续性肾脏替代治疗(CRRT)为主的综合性治疗进程中不同时相点的尿量变化,同时利用彩超观测其相应时相点的肾脏血流阻力指数改变,分析少尿期、多尿期患者尿量变化与肾脏血流阻力指数改变之间的相关性。结果:挤压综合征患者CRRT治疗进程中尿量变化呈现为由少尿、无尿到多尿,最后到尿量平稳的过程,肾血流阻力指数表现为由高阻到阻力下降,最后到正常血流阻力的变化特点,少尿期、多尿期日尿量变化与肾脏血流阻力指数改变之间呈负相关(r=-0.91,P<0.01)。结论:挤压综合征患者CRRT治疗进程中少尿期、多尿期尿量变化与肾脏血流阻力指数改变之间具有很好的相关性,提示超声监测肾脏血流阻力指数变化可作为评价疗效及判断预后的较敏感、客观、便捷指标之一。
Objective:To explore the correlation between changes of urine volume and renal blood flow resistance index(RI)in patients with earthquake-induced crush syndrome and its significance.Methods:The changes of urine volume at different time points in nine cases with earthquake-induced crush syndrome were monitored during their continuous renal replacement therapy(CRRT)-based synthetic treatment.Meanwhile,the changes of renal blood flow RI at the same time points were monitored by color Doppler ultrasound system.The correlation between the urine volume in oliguria and diuresis stages and the renal blood flow RI was analyzed eventually.Results:During the CRRT process,the urine volume of patients with crush syndrome changed from the oliguria or anuria to the diuresis and finally to normal level,and the renal blood flow RI changed from high resistance to low resistance and finally to normal resistance.The correlation between the urine volume and renal blood flow RI was very significantly negative(r=-0.91,P<0.01).Conclusion:During the CRRT process,the changes of urine volume in patients with crush syndrome are highly correlated to renal blood flow RI.Therefore,the changes of renal blood flow RI monitored by the color Doppler ultrasound can be used as a sensitive,objective and convenient index for evaluating curative effect and judging prognosis.
Objective:To explore the correlation between changes of urine volume and renal blood flow resistance index(RI)in patients with earthquake-induced crush syndrome and its significance.Methods:The changes of urine volume at different time points in nine cases with earthquake-induced crush syndrome were monitored during their continuous renal replacement therapy(CRRT)-based synthetic treatment.Meanwhile,the changes of renal blood flow RI at the same time points were monitored by color Doppler ultrasound system.The correlation between the urine volume in oliguria and diuresis stages and the renal blood flow RI was analyzed eventually.Results:During the CRRT process,the urine volume of patients with crush syndrome changed from the oliguria or anuria to the diuresis and finally to normal level,and the renal blood flow RI changed from high resistance to low resistance and finally to normal resistance.The correlation between the urine volume and renal blood flow RI was very significantly negative(r=-0.91,P<0.01).Conclusion:During the CRRT process,the changes of urine volume in patients with crush syndrome are highly correlated to renal blood flow RI.Therefore,the changes of renal blood flow RI monitored by the color Doppler ultrasound can be used as a sensitive,objective and convenient index for evaluating curative effect and judging prognosis.
引文
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[2]DEMIRKIRANO,DIKMENY,UTKUT,et al.Crush syndrome patients after the Marmara earthquake[J].EmergMed J,2003,20(3):247-250.
[3]VANHOLDER R,VAN DER TOL A,DE SMET M,et al.Earthquakes and crush syndrome casualties:lessons learned from the Kashmir disaster[J].Kidney Int,2007,71(1):17-23.
[4]ROKACH A,BAR-DAYAN Y.Crush-related injury after disasters[J].NEngl J Med,2006,354(23):2511-2512.
[5]SMITHJ,GREAVES I.Crush injury and crush syndrome:a review[J].J Trauma,2003,54(5Suppl):S226-230.
[6]刘芳,付平,陶冶,等.地震灾害后挤压综合征及急性肾功能衰竭救治——汶川地震特稿[J].中国实用内科杂志,2008,28(7):895-897.
[7]MEHMETS S,RAYMEND V,NORBERTI.Management of crush-related injuries after disasters[J].N Engl J Med,2006,354(10):1052-1063.
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