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术中和术后肾功能衰竭是麻醉和手术的严重并发症.危重病人对缺血性损害更为敏感.维持重要脏器的灌注对防止急性肾功能衰竭是极其重要的.一、急性肾功能衰竭的病理生理在涉及手术的大多数情况下,急性肾衰是肾脏对继发性低血压、低血容量和/或脱水引起的急性缺血的一种反应.不管血压是否降低,血容量减少和心衰均可引起肾血管收缩,从而导致肾血流降低.即使心排血量正常或甚至增加的情况下,也可能发生肾脏的低灌注.此外,很多体液因素可使原先灌注肾脏的心排血量转移至其它脏器,从而导致明显的肾血管收缩.(一)肾血流和氧供
Intraoperative and postoperative renal failure is a serious complication of anesthesia and surgery.Acute patients are more susceptible to ischemic damage.Purpose to maintain vital organs perfusion is extremely important to prevent acute renal failure.Acute renal function Pathophysiology of failure In most cases involving surgery, acute renal failure is a reaction of the kidneys to secondary ischemia, hypovolemia and / or dehydration-induced acute ischemia. Whether or not blood pressure is reduced, hypovolemia And heart failure can cause renal vasoconstriction, resulting in decreased renal blood flow.Even if the cardiac output is normal or even increased, low perfusion of the kidneys may occur.In addition, many of the body fluids can make the heart of the original perfusion of the kidneys Blood transfusion to other organs, resulting in significant renal vasoconstriction. (A) renal blood flow and oxygen supply