论文部分内容阅读
目的:分析并讨论对于脑梗死与脑出血患者使用甘露醇而导致急性肾功能衰竭的临床特征,发病要点以及治愈后的防治等。方法:对过去9个月在我院治疗脑出血与脑梗死过程中因使用甘露醇而并发急性肾功能衰竭的49例患者进行回顾分析。尤其对于其致病机理、临床表现及预后原因等进行分析研究。结果:49例患者均为因使用甘露醇而致急性肾功能衰竭的老年患者。平均年龄66.4±2.8岁。其中,无尿、少尿患者人数分别为10、21例,约占总人数的63.2%。尿血患者约占总人数的53%,共计26例。且研究表明甘露醇用量越大患者出现尿血现象越早。同时,研究表明,急性肾功能衰竭患者的死亡率不仅与甘露醇用量存在密切关系,而且同治疗手段是否采用血液透析等均有密切关系。结论:高龄老年患者(68岁以上)在脑梗死与脑出血治疗中使用甘露醇更易引发急性肾功能衰竭,患者总死亡率高。多数急性肾功能衰竭患者均因脑疝、身体多器官功能衰竭以及消化道出血而致死。其中,甘露醇用量多少起关键作用。
OBJECTIVE: To analyze and discuss the clinical features of acute renal failure caused by the use of mannitol in patients with cerebral infarction and intracerebral hemorrhage, the main points of onset and the prevention and treatment after the cure. Methods: A retrospective analysis was performed on 49 patients with mannitol and acute renal failure during the past 9 months in our hospital for the treatment of cerebral hemorrhage and cerebral infarction. Especially for its pathogenesis, clinical manifestations and prognosis of causes such as analysis. Results: All 49 patients were elderly patients with acute renal failure due to the use of mannitol. The average age was 66.4 ± 2.8 years. Among them, the number of anuria, oliguria patients were 10,21 cases, accounting for about 63.2% of the total number. Hematuria accounted for about 53% of the total number of patients, a total of 26 cases. And research shows that the greater the amount of mannitol in patients with hematuria earlier. At the same time, studies have shown that mortality in patients with acute renal failure is not only closely related to the amount of mannitol, but also with the treatment of hemodialysis are closely related. Conclusion: The elderly patients (over 68 years old) are more likely to cause acute renal failure with mannitol in the treatment of cerebral infarction and cerebral hemorrhage. The total mortality rate is high. Most patients with acute renal failure due to hernia, multiple organ failure and gastrointestinal bleeding and death. Among them, the amount of mannitol play a key role.