创伤性挤压综合征急性肾功能衰竭的超声评价
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摘要
目的探讨超声评价创伤性挤压综合征并发急性肾衰竭(ARF)及监测临床治疗效果的价值。方法回顾性分析10例地震伤挤压综合征急性肾功能衰竭患者的超声检查与临床资料,并与同期单纯四肢骨折伤患者资料进行对照。结果10例并ARF患者中,肌酐(Scr)水平及尿素氮(BUN)水平均显著升高(P<0.01),双肾体积增大、动脉阻力指数增高(P<0.01),其中7例患者入院时人血白蛋白水平明显降低(P<0.01),经治疗后均恢复正常。结论超声对挤压综合征患者肾功能评价及监测临床治疗效果具有较大的价值。
Objective To explore early diagnosis parameters and some methods to diagnose acute renal failure(ARF)in severely crush injury.Methods Clinical data of 10 patients with ARF in severe crush injury following earthquake was analyzed.Ten patients with pure four limbs fracture were enrolled as the control group.Results Compared with the control group,the level of Sera creatinine(Scr)and blood urea nitrogen(BUN)in ARF group increased significantly(P<0.01),so did the volume and artery resistant index(RI)of both kidney(P<0.01),while the level of sera albumin depressed significantly(P<0.01).Conclusion Ultrasonic examination is valuable in evaluating the secondary damage in renal function following earthquake and monitoring therapeutic efficacy.The lost of sera albumin may play a vital role in patients of ARF resulted by earthquake.
Objective To explore early diagnosis parameters and some methods to diagnose acute renal failure(ARF)in severely crush injury.Methods Clinical data of 10 patients with ARF in severe crush injury following earthquake was analyzed.Ten patients with pure four limbs fracture were enrolled as the control group.Results Compared with the control group,the level of Sera creatinine(Scr)and blood urea nitrogen(BUN)in ARF group increased significantly(P<0.01),so did the volume and artery resistant index(RI)of both kidney(P<0.01),while the level of sera albumin depressed significantly(P<0.01).Conclusion Ultrasonic examination is valuable in evaluating the secondary damage in renal function following earthquake and monitoring therapeutic efficacy.The lost of sera albumin may play a vital role in patients of ARF resulted by earthquake.
引文
[1]Wang LJ.Crushinjury and multiple organ dysfunction syndrome.Chinese Journal of Coal Industry Medicine,2004,7(10):907-909.王立金.挤压伤与多器官功能不全综合征.中国煤炭工业医学杂志,2004,7(10):907-909.
[2]Zhong HJ,Yang TD.Crush syndrome and earthquake.Guide of China Medicine,2008,6(5):3-6.钟河江,杨天德.地震与挤压综合征.中国医药指南,2008,6(5):3-6.
[3]Liu LP,Liu WP,Kang CS.Evaluation of ultrasoundin acute renal failure.Chin J Med I maging Technol,2003,19(2):249-251.刘利平,刘望彭,康春松.超声评价急性肾衰竭.中国医学影像技术,2003,19(2):249-251.
[4]He J.Value of ultrasoundin diagnosing acute renal failure resulted fromfire burn.Journal of North Sichuan Medical College,2008,23(4):379-381.何君.超声在烧伤致急性肾衰竭诊断中的应用价值.川北医学院学报,2008,23(4):379-381.
[5]Gunal AI,Celiker H,Dogukan A,et al.Early and vigorous fluid resuscitation prevents acute renal failureinthe crush victi ms of cat-astrophic earthquakes.J Am Soc Nephrol,2004,15(7):1862-1867.
[6]Atef-Zafarmand A,Fadem S.Disaster nephrology:medical per-spective.Adv Ren Replace Ther,2003,10(1):104-116.
[7]Hatamizadeh P,Najafi I,Vanholder R,et al.Epidemiologic as-pects of the bamearthquake in iran:the nephrologic perspective.AmJ Kidney Dis,2006,47(3):428-438.
[2]Zhong HJ,Yang TD.Crush syndrome and earthquake.Guide of China Medicine,2008,6(5):3-6.钟河江,杨天德.地震与挤压综合征.中国医药指南,2008,6(5):3-6.
[3]Liu LP,Liu WP,Kang CS.Evaluation of ultrasoundin acute renal failure.Chin J Med I maging Technol,2003,19(2):249-251.刘利平,刘望彭,康春松.超声评价急性肾衰竭.中国医学影像技术,2003,19(2):249-251.
[4]He J.Value of ultrasoundin diagnosing acute renal failure resulted fromfire burn.Journal of North Sichuan Medical College,2008,23(4):379-381.何君.超声在烧伤致急性肾衰竭诊断中的应用价值.川北医学院学报,2008,23(4):379-381.
[5]Gunal AI,Celiker H,Dogukan A,et al.Early and vigorous fluid resuscitation prevents acute renal failureinthe crush victi ms of cat-astrophic earthquakes.J Am Soc Nephrol,2004,15(7):1862-1867.
[6]Atef-Zafarmand A,Fadem S.Disaster nephrology:medical per-spective.Adv Ren Replace Ther,2003,10(1):104-116.
[7]Hatamizadeh P,Najafi I,Vanholder R,et al.Epidemiologic as-pects of the bamearthquake in iran:the nephrologic perspective.AmJ Kidney Dis,2006,47(3):428-438.
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