肾脏替代治疗在地震伤挤压综合征患者保肢中的应用
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摘要
目的分析肾脏替代治疗在汶川大地震后挤压综合征患者保肢治疗中的作用和预后,探讨肾脏替代治疗与手术相结合的模式和优点。方法对31例挤压综合征合并急性肾功能衰竭患者行床旁透析治疗,其中30例行急诊手术治疗。结果死亡4例,1例在1肢截肢平面上再截肢。其余患者采用肾脏替代治疗后肾功能在7~23天恢复,切开减压创面经换药、二期缝合或植皮愈合,患肢得以保存。结论肾脏替代治疗能快速、有效地改善患者肾脏功能,纠正高血钾及代谢性酸中毒,合理地与手术相结合,能为保存患者生命和肢体提供重要的保障。
引文
[1]Vanholder R,VanBiesen W,Lameire N,et al.The role of the internationalsociety of nephrology/renal disaster relief task force in the rescue of renaldisaster victims[J].Contrib Nephrol,2007,15(6):325-332.
[2]Sever MS,Vanholder R,Lameire N.Management of crush-related injuriesafter disasters[J].N Engl J Med,2006,354(10):1052-1063.
[3]Gonzalez D.Crush syndrome[J].Crit Care Med,2005,33(1 Suppl):S34-41.
[4]Zager RA.Rhabdomyolysis and myohemoglobinuric acute renal failure[J].Kidney Int,1996,49(2):314-326.
[5]Better OS,Rubinstein I,Reis DN.Muscle crush compartment syndrome:fulminant local edema with threatening systemic effects[J].Kidney Int,2003,63(3):1155-1157.
[6]Sever MS,Erek E,Vanholder R,et al.Clinical findings in the renal vic-tims of a catastrophic disaster:the Marmara earthquake[J].Nephrol Dialtransplant,2002,17(11):1942-1649.
[7]Michaelson M.Crush injury and crush syndrome[J].World J Surg,1992,16(3):899-903.
[2]Sever MS,Vanholder R,Lameire N.Management of crush-related injuriesafter disasters[J].N Engl J Med,2006,354(10):1052-1063.
[3]Gonzalez D.Crush syndrome[J].Crit Care Med,2005,33(1 Suppl):S34-41.
[4]Zager RA.Rhabdomyolysis and myohemoglobinuric acute renal failure[J].Kidney Int,1996,49(2):314-326.
[5]Better OS,Rubinstein I,Reis DN.Muscle crush compartment syndrome:fulminant local edema with threatening systemic effects[J].Kidney Int,2003,63(3):1155-1157.
[6]Sever MS,Erek E,Vanholder R,et al.Clinical findings in the renal vic-tims of a catastrophic disaster:the Marmara earthquake[J].Nephrol Dialtransplant,2002,17(11):1942-1649.
[7]Michaelson M.Crush injury and crush syndrome[J].World J Surg,1992,16(3):899-903.
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