目的:探讨住院患者急性肾功能衰竭(ARF)的临床病因方法:回顾性分析139例ARF患者的临床资料,探讨其病因、肾衰类型及危险因素。结果:139例ARF患者中,肾前性90例,肾性37例,肾后性12例。其中,60岁以上的老年人73例,占52.5%。引起ARF的根本病因中,感染、心衰及创伤为引起ARF的主要病因。结论:注意有效血容量不足的症状及体征、及时扩容及控制感染可以减少ARF的发生。同时,60岁以上老年人仍是高危人群,应重在预防。
【摘要】 目的 探讨开展优质护理服务对早期慢性肾功能衰竭患者治疗的影响。 方法 将2009年9月-2010年6月收治的80名早期慢性肾功能衰竭患者，随机分成对照组和试验组，每组各40例。试验组实施优质护理服务，对照组按常规护理，半年后采用自测健康评定量表（SRHMS V1.0）对患者进行问卷调查，从而了解和评判优质服务对早期慢性肾功能衰竭患者治疗的影响及效果。 结果 试验组在器官功能、日常生活功能、生理健康子量表总分3个维度，在负向情绪、正向情绪、认知功能、心理健康子量表总分4个维度，在角色活动、社会健康子量表总分2个维度与对照组比较，差异均有统计学意义（Plt;0.05），在社会支持和社会资源方面与对照组的差异无统计学意义（Pgt;0.05）。 结论 开展优质护理服务能明显提高患者治疗疾病的信心，对有效控制患者病情发展有一定的影响与作用。【Abstract】 Objective To investigate the impact of quality care on early chronic renal failure patients. Methods Eighty patients in early stages of chronic renal failure in our department between September 2009 and June 2010 were randomly divided into the control group and the experimental group with 40 patients in each group. Quality and Conventional care were implemented on the two groups respectively. Six months later, self-rated health measurement scale (SRHMS V1.0) was used to analyze the impact of quality care on the patients. Results The results of the measurement showed that there were significant differences between the two groups in organ function, daily life function, physiologic health, negative emotion, positive emotion, cognitive ability, psychological health, role activity and social health (Plt;0.05). There were no significant differences between them in social support and social resources. Conclusion Carrying out high-quality care can significantly improve the active treatment confidence of the patients and can effectively control the development of the disease.
Chronic kidney disease (CKD) is now recognized as a worldwide public health challenge, and the incidence rate and hospitalization rate have significantly increased in recent years. Without prompt diagnoses and effective treatment in the early renal function damage of CKD, the symptoms will continue to worsen and eventually develop into end-stage renal disease. Functional imaging techniques such as single photon emission computed tomography (SPECT), contrast-enhanced ultrasound (CEUS), computerized tomography perfusion (CTP), and magnetic resonance perfusion weighted imaging (MR-PWI) could be used to quantitatively analyze renal perfusion and renal filtration function. Their diagnostic values are increasingly evident and have become the research hotspot in evaluating renal function. The aim of this review is to briefly evaluate the research and application advances in the early renal function damage assessment of CKD, so as to raise the efficiency of clinical applications.
【摘要】 目的 报道1例静脉滴注胺碘酮致肝肾功能不全患者。 方法 2010年10月收治1例扩张性心肌病患者，治疗过程中使用胺碘酮注射液，导致严重的肝肾功能不全。系统查阅中国期刊全文数据库及外文数据库Pubmed、Embase建库至2011年8月关于胺碘酮致肝肾功能不全的相关文献，进行静脉胺碘酮致肝肾功能不全的可能性评估，探索胺碘酮静脉滴注致肝功能不全的的作用机制。 结果 根据查阅文献结果分析，此患者静脉注射胺碘酮致肝功不全的可能性高，Naranjo概率评分分别为7分。 结论 提出临床医师和临床药师应进行胺碘酮静脉的药学监护，高度的重视胺碘酮相关的不良反应，从而及时识别和防治胺碘酮所致肝肾功能不全，减少其不良预后。【Abstract】 Objective To report a case of hepatic and renal insufficiency induced by intravenous injection with amiodarone, and to evaluate the possibility of the adverse drug reaction. Methods A patient with dilated cardiomyopathy was admitted in October, 2010. During the procedure, the use of amiodarone hydrochloride injection made the patient suffer from liver and kidney dysfunction. We retrieved the literatures about liver and kidney toxicity of amiodarone from CNKI, Pubmed, and Embase (from the establishment of the databases to November 2011). We also ssessed the possibility of the adverse drug reaction, discussed the mechanism of amiodarone-induced hepatic insufficiency. Results According to the literature, There was a great possibility of hepatic insufficiency induced by amiodarone, and the total score of the Naranjo probability score was 7. Conclusion It is important to pay more attention to the pharmaceutical care of amidarone to timely recognize and effectively prevent or treat hepatic and renal insufficiency induced by intravenous injection with amiodarone.
目的 探讨连续肾脏替代疗法（CRRT）对ICU急性肾功能衰竭（ARF）患者的血浆细胞因子、肾功能指标及其预后的影响。方法 选取我科2002年6月至2003年11月符合ARF的ICU患者38例，其中治疗组20例采用CRRT治疗，对照组18例采用肾脏非替代治疗（保守治疗）。两组患者于治疗前、后分别抽取静脉血标本作血浆细胞因子和肾功能指标的检测，并统计两组患者的临床死亡病例数。 结果 与对照组比较，治疗组的血浆肿瘤坏死因子、白细胞介素-6、白细胞介素-8及血肌酐和血尿素氮水平有显著改善（P＜0.05），而临床死亡率改变不明显（Pgt;0.05）。结论 CRRT能有效清除ICU的ARF患者的炎性细胞因子，改善肾功能指标，但其最终预后仍然很差。对于ICU的ARF患者，应该强调预防的重要性。
Experienc of nurtitional treatment to 7 patients with acute renal failure (ARF) and nitrogemia after biliarty (tract) surgery is reported in this article. Nittrogen source inn all cases was obtained from "Renal Amine" and "7% Vamin" etc,which are composed of 8 essential amino acids (EAA), and the nergery sources are mainly supplyed by Intralipid (20 or 10%) and suitable amount of glucose. The nutritional admicture of "all in one" were employed as parenteral nutrition (PN). Satisfactary curative effecs in these patients were obtained. The suthors consider that (a) the nutritional treatment of different casuses of ARF should be providing enough energy and more EAA requirments than in normal need to synthesizw non-essential amino acide (NEAA) and protein from excessive blood urea nitrogen (BUN) for redcuing pritein breakdown and nitrogemia, and (b) 20% Intralipid is an effective low-volume, highly calories nutritional agent specially in ARF patients with restiction of waterr.
ObjectiveTo observe whether proteinuria is relate to the decline of residual renal function (RRF) in peritoneal dialysis (PD) patients. MethodsThis is a prospective cohort study including 45 PD patients (underwent PD between January 2011 and January 2013) with a 12-month follow-up. All the patients were divided into 2 groups with respect to the initial proteinuria level: massive proteinuria group A (n=20) and non-massive proteinuria group B (n=25) at baseline. We established regression models to do univariate analysis and multivariate analysis of the relationship between the decline of RRF≥50% of baseline and the indices of age, sex, PD-associated peritonitis, baseliner residual glomerular filtration rate (rGFR), initial proteinuria, and use of ACEI/ARB. ResultsThe primary outcome (RRF>50% of baseline) at 12 months was 65% in group A, and 80% in group B (P<0.05). Based both on the results of univariate and multivariate Cox regression analysis, non-massive proteinuria and higher rGFR at baseline were factors to protect RRF from decline (P<0.05). ConclusionThe study demonstrates that massive proteinuria and lower rGFR at baseline may be associated with a rapid decline of RRF in PD patients. Treatment aimed at reducing albuminuria may lead to protect RRF and improve life quality of patients.
目的：研究羟甲戊二酰辅酶A还原酶抑制剂辛伐他汀治疗慢性肾功能不全的临床疗效。方法：选择慢性肾功能衰竭患者共40例，随机分成两组，在原有基础治疗上治疗组20例患者予以辛伐他汀治疗，对照组20例单纯以基础治疗，在24周时监测TC、TG、24 h尿蛋白、Scr、BUN、C-反应蛋白的值。结果：与治疗前相比，两组TC、TG、24 h尿蛋白、Scr、BUN、C-反应蛋白均明显下降，与对照组相比，治疗组血脂有显著下降（P＜0.01）而且24h尿蛋白、Scr、BUN、C-反应蛋白均明显下降(P＜0.05)。结论：辛伐他汀能降低蛋白尿，延缓慢性肾功能不全的进展