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[尿路结石合并慢性肾衰竭患者体液和血液动力学紊乱的纠正]

[The correction of the humoral and hemodynamic disorders in patients with urolithiasis complicated by chronic kidney failure].

作者信息

Neĭmark A I

出版信息

Urol Nefrol (Mosk). 1992 Jul-Dec(4-6):16-8.

PMID:1475869
Abstract

The paper presents the analysis of 52 cases of urolithiasis complicated by chronic renal failure in the intermittent stage. The patients were examined for renal blood flow, central hemodynamics, myocardial function, factors of humoral regulation of the circulation kallikrein-kinin, sympathoadrenal systems, renin activity, renal function. The test were performed preoperatively and 1, 3, 7, 14 days after surgery. The patients entered two groups. 24 patients of group I received routine symptomatic treatment, 28 patients of group II were treated with regard to the changes revealed and underwent preoperative enterosorption. Group I demonstrated severe shifts in renal and central hemodynamics, reduction of renal circulation, hypokinetic circulatory syndrome, phasic syndrome of myocardial hypodynamics, hypoactivity of kallikrein-kinin and sympathoadrenal systems, hyperactivity of renin. The disturbances aggravated postoperatively and disappeared only on day 14 since the operation. having been corrected by cardiac glycosides, desaggregants, hypotensive drugs diuretics. Group II patients developed increased renal circulation, weak activation of humoral blood regulation factors. Hemodynamic disorders showed no progression. As a results, renal postoperative function improved.

摘要

本文对52例处于间歇期的尿石症合并慢性肾衰竭患者进行了分析。对患者进行了肾血流、中心血流动力学、心肌功能、循环激肽释放酶-激肽体液调节因子、交感肾上腺系统、肾素活性及肾功能的检查。检查在术前以及术后1天、3天、7天、14天进行。患者分为两组。第一组24例患者接受常规对症治疗,第二组28例患者根据所发现的变化进行治疗并在术前进行肠吸附。第一组表现出肾和中心血流动力学的严重改变、肾循环减少、低动力循环综合征、心肌低动力相综合征、激肽释放酶-激肽和交感肾上腺系统功能低下、肾素活性亢进。这些紊乱在术后加重,直到术后第14天才消失,通过强心苷、解聚剂、降压药和利尿剂得以纠正。第二组患者肾循环增加,体液血液调节因子激活较弱。血流动力学紊乱未进展。结果,术后肾功能得到改善。

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