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ARF系有效肾单位功能不全或损害坏死,丧失调节机能,以发生水、电解质、氮质代谢紊乱和酸碱失衡,产生自身中毒综合征。临床上处理的关键是:消除病因,改善肾脏血流,维持体液、氮质代谢的内环境平衡,使已受损害的肾功能单位逐渐得以恢复。为此,对ARF的处理上调节体液代谢至为重要,今就临床常遇的几个问题,扼要探讨如下: 一、分析病因,相应处理凡患者突然发生少尿型或非少尿型氮质血症,血尿素氮、肌酐不断升高超过24小时者,都需考虑有ARF的可能。有二种因素要作考虑:1.急性肾血流量减少,肾缺血肾小球滤过率骤降。2.急性肾小管坏死或药物毒害产生急性间质性肾炎或肾中毒所致。肾脏是休克早期的主要靶器官。感染性败血休克和急重病患者往往可并发肾衰,如心
ARF Department of nephron function is not effective or damage necrosis, loss of regulatory function, in order to produce water, electrolytes, nitrogen metabolism disorders and acid-base imbalance, resulting in their own poisoning syndrome. The key to clinical treatment is: to eliminate the cause, improve renal blood flow, maintain body fluid, nitrogen metabolism of the internal environment balance, so that damaged renal function units gradually restored. To this end, the treatment of ARF on the regulation of body fluid metabolism is important, now the clinical often encountered several issues, briefly discussed as follows: First, analyze the cause, the corresponding treatment Where the patient suddenly oliguria or non-oliguric nitrogen Serum, blood urea nitrogen, creatinine rising more than 24 hours, need to consider the possibility of ARF. There are two factors to be considered: 1. Acute renal blood flow decreased, renal ischemia glomerular filtration rate plummeted. Acute tubular necrosis or poisoning caused by acute interstitial nephritis or renal toxicity. Kidney is the main target organ of early shock. Infectious septic shock and critically ill patients often can be complicated by renal failure, such as the heart