Mazin V V, Dubrov A I, Zhukov A A
Urol Nefrol (Mosk). 1992 Jul-Dec(4-6):29-30.
The paper presents the review of the treatment performed in 183 patients with acute renal failure caused by trauma, myorenal syndrome, surgical, obstetric and urological lesions. All the patients underwent hemodialysis. The majority of the patients manifested hypoxia due to pulmonary edema and abnormal central and visceral hemodynamics, anemia resultant from blood loss and suppression of hemopoiesis, impairment of tissue oxidation-reduction enzymes by uremic toxins. Hemodialysis aggravated hypoxia. A direct relationship existed between arterial hypoxemia and the degree of metabolic acidosis, electrolyte alterations and residual diuresis in oligoanuric stage of acute renal failure. The treatment of 48 relevant patients involved 5-10 sessions of hyperbaric oxygenation (1.5-2.2 atm for 60-90 min). The session usually followed hemodialysis. The response was achieved in arterial hypoxemia, central hemodynamics, peripheral blood, water-electrolyte balance, acid-base equilibrium, uremic intoxication. The frequency of hemodynamic reactions during hemodialysis and pyoseptic complications induced by uremia reduced as well as the need in urgent hemodialysis. The introduction of hyperbaric oxygenation diminished the lethality by 29%.
本文介绍了对183例由创伤、肌肾综合征、外科、产科及泌尿科病变引起的急性肾衰竭患者所进行的治疗情况。所有患者均接受了血液透析。大多数患者表现出因肺水肿以及中枢和内脏血流动力学异常导致的缺氧、失血及造血受抑制引起的贫血、尿毒症毒素对组织氧化还原酶的损害。血液透析加重了缺氧。在急性肾衰竭少尿期，动脉血氧不足与代谢性酸中毒程度、电解质改变及残余尿量之间存在直接关系。48例相关患者的治疗包括进行5至10次高压氧治疗（1.5至2.2个大气压，持续60至90分钟）。治疗通常在血液透析之后进行。在动脉血氧不足、中枢血流动力学、外周血、水电解质平衡、酸碱平衡及尿毒症中毒方面均取得了疗效。血液透析期间血流动力学反应的频率以及尿毒症引起的脓毒症并发症减少，紧急血液透析的需求也减少。高压氧治疗的引入使死亡率降低了29%。
