Bissinger R L
Neonatal Netw. 1995 Jun;14(4):9-20.
To assess, plan, and implement care of the critically ill neonate, the nurse must have a thorough understanding of renal embryology and physiology. This articles focuses on the developmental and anatomical structure of the kidney and the general physiological activities of the renal components. Renal embryological development begins during the 1st week of gestation and continues until around the 36th week of gestation. Functional capacity, although not mature, begins around the 6th week of gestation. Infants born premature have underdeveloped structures and decreased renal function. Comprehending renal anatomy and physiology requires a complete understanding of a single nephron, the functional unit of the kidney. Each nephron consists of a glomerulus, Bowman's capsule, and tubules, which work together to maintain ion balance for cellular function and elimination of unwanted substances from the plasma. Renal blood flow, controlled by either autoregulation or hormonal control, must remain both rapid and constant for glomerular filtration to occur. Alterations in any of these components of renal anatomy and physiology will alter the condition of the neonate. Renal evaluations are done based on output, urine chemistries, and serum chemistries. These evaluations lead to a diagnosis on which the nurse can base her plan of care.
为了评估、规划和实施对危重新生儿的护理，护士必须对肾脏胚胎学和生理学有透彻的了解。本文重点关注肾脏的发育和解剖结构以及肾脏各组成部分的一般生理活动。肾脏胚胎发育始于妊娠第1周，并持续到妊娠第36周左右。虽然功能尚未成熟，但在妊娠第6周左右开始具备功能。早产婴儿的结构发育不全，肾功能下降。理解肾脏解剖学和生理学需要对单个肾单位（肾脏的功能单位）有全面的了解。每个肾单位由一个肾小球、鲍曼囊和肾小管组成，它们共同作用以维持细胞功能所需的离子平衡，并从血浆中清除不需要的物质。肾血流受自身调节或激素控制，必须保持快速且恒定，才能发生肾小球滤过。肾脏解剖学和生理学的这些组成部分中任何一个发生改变，都会改变新生儿的状况。肾脏评估基于尿量、尿液化学分析和血清化学分析进行。这些评估得出的诊断结果是护士制定护理计划的依据。
