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本文对我科近年来收治的64例急症闭合性肾损伤,应用大剂量静脉尿路造影检查的有关问题进行了讨论。急症创伤由于病情危重,造影前除作碘过敏试验外,无需特殊准备。造影剂要大剂量、快速静脉滴注,5分钟后拍片,对于极危重病人应造影与抢救同时进行。作者认为只要血压维持在12/6.7kPa(90/50mmHg)以上,甚至有急性肾功能衰竭或严重双肾损伤者,仍可进行该项检查。作者指出大剂量静脉尿路造影无严重反应,对疑为肾损伤者,除少数同时合并心、肝严重损害外,均应早期常规施行大剂量静脉尿路造影检查。
In this paper, 64 cases of acute renal failure in our department in recent years, the application of high-dose intravenous urography examination of the issues were discussed. Acute traumatic injury due to critical condition, in addition to contrast imaging before iodine allergy test, without special preparation. Contrast to large doses, rapid intravenous infusion, 5 minutes after the film, for critically ill patients should be angiography and rescue at the same time. The authors believe that the test can still be performed as long as the blood pressure is maintained at 12 / 6.7kPa (90 / 50mmHg) or even acute renal failure or severe renal impairment. The authors point out that high-dose intravenous urography without serious reaction to suspected kidney injury, in addition to a small number of simultaneous heart and liver damage, should be routinely carried out early high-dose intravenous urography.