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扩容剂脱水剂是临床常用药物,用量较大,引起肾损伤临床上较少见,现将近几年文献中有关扩容剂脱水剂引起肾功能损伤的报道概述如下:1 羟乙基淀粉(706代血浆)该药有很好的扩容及改善微循环作用.王福安,于学红报道6例用其治疗的不稳定性心绞痛、脑梗死、下肢闭塞性动脉硬化症等患者,用前尿量均正常,SCr异常3例,用羟乙基淀粉500ml,qd,用药6d～14d后出现少尿或无尿(用药期间未用任何可致肾损害的药物)且SCr均>700μmol/L,停药后用利尿剂、血液净化等治疗,4例因尿毒症死亡,1例自动出院,仅1例肾功能较快恢复.作者认为引起肾衰原因与该药在血中存留时间较长(24h血中存留50%,48h血中30%),连续应用时易产生蓄积中毒,易引起急性肾衰有关.提示临床应严格掌握应用指征、剂量,特别是对老年病人应提倡短期应用,用药期间密切监测肾功能.肾功能减退或少尿者慎用.
Expansion agent dehydration agent is commonly used in clinical medicine, a larger amount, causing renal injury clinically rare, now in the literature about the expansion agent dehydration agent caused renal damage reports are summarized as follows: 1 hydroxyethyl starch (706 generation Plasma) the drug has a good expansion and improve microcirculation.Fang Fuan, Yu Xuehong reported in 6 cases of treatment of unstable angina, cerebral infarction, lower extremity occlusive arteriosclerosis and other patients, the use of urine before Normal, SCr abnormalities in 3 cases, with hydroxyethyl starch 500ml, qd, 6d ~ 14d after treatment of oliguria or anuria (during treatment without any can cause kidney damage) and SCr were> 700μmol / L, withdrawal After diuretics, blood purification and other treatment, 4 cases of death due to uremia, 1 patient was discharged automatically, only 1 case of rapid recovery of renal function. The author believes that the causes of renal failure and the drug in the blood longer retention time (24h blood In the retention of 50%, 48h blood 30%), continuous application is easy to produce accumulation poisoning, easily lead to acute renal failure.It is suggested that clinical indications should be strictly applied, dosage, especially for elderly patients should promote short-term application, during the medication Closely monitor renal function, renal dysfunction or oliguria with caution.