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急性肾衰本身并不一定致命,只要处理得当可渡过难关,否则,多死于并发症。急性肾衰除死于原发病外,据中山医学院第一附属医院的一组材料,约有1/3死于肾衰及其并发症。充血性心衰这是急性肾衰少尿期的主要死亡原因。常由于下述原因导致血容量增加所致: 1、对急性肾衰未能做出早期诊断,将少尿误为休克或血容不足,以致大量输液造成心脏负荷过重。 2、纠正酸中毒过于积极,当CO_2CP>30V_0 1％时,仍继续输碳酸氢钠液。 3、当Hb已超过6克％,仍做不必要的输血。 4、未能严格执行量出为入的原则,过多输入液体和钠盐。诊断对典型的急性左心衰(急性肺水肿),诊断并不难,关键在于能否于急性肺水肿出现之前,早期判断出心功不全。早期诊断的依据:①劳力性呼吸困难及夜间阵发呼吸困难;两肺底湿啰音,肺泡呼吸音减弱。②胸
Acute renal failure itself is not necessarily fatal, as long as properly handled can tide over the crisis, otherwise, died of complications. In addition to acute primary renal failure died of primary disease, according to a set of materials at the First Affiliated Hospital of Zhongshan Medical College, about 1/3 died of renal failure and its complications. Congestive heart failure This is the main cause of death from oliguria in acute renal failure. Often due to the following reasons caused by increased blood volume: 1, failed to make an early diagnosis of acute renal failure, oliguria misdiagnosed as shock or hypovolemia, resulting in a large number of infusion caused by heart overload. 2, to correct acidosis is too positive, when CO_2CP> 30V_0 1%, still continue to lose sodium bicarbonate solution. 3, when Hb has more than 6 grams, still do unnecessary blood transfusion. 4, failed to strictly enforce the amount of income as the principle of excessive input liquid and sodium salt. Diagnosis of the typical acute left heart failure (acute pulmonary edema), the diagnosis is not difficult, the key lies in the possibility of acute pulmonary edema before the early determination of cardiac insufficiency. The basis of early diagnosis: ① exertional dyspnea and intermittent breathing difficulties at night; two lung wet rales, alveolar breath sounds weakened. ② chest