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在48例伴有Ⅲ或Ⅳ度脑病的暴发型肝功能衰竭病人中,38例显示肾功能损害,血浆尿素或肌酐增高。其中32例的病因可分为三类:(1)肾前性尿毒症4例;其中3例因失水所致,补液后血浆尿素即下降;另1例因消化道出血后吸收氮质产物所致。(2)功能性肾衰竭12例:特征为低尿钠(<18毫当量/升),尿沉渣正常及尸检肾无病变。功能性肾衰竭与肝坏死的原因、治疗方法及肝功能试验的变化无关。速尿及甘露醇皆无疗效,其中3例治疗后尿量虽增多,但血
Of the 48 patients with fulminant hepatic failure who had grade III or IV encephalopathy, 38 showed impaired renal function and increased plasma urea or creatinine. Of which 32 cases of the etiology can be divided into three categories: (1) 4 cases of prerenal uremia; of which 3 cases due to dehydration caused by fluid urea after the fall; the other 1 case of gastrointestinal bleeding due to absorption of nitrogen products Due. (2) 12 cases of functional renal failure: characterized by low urinary sodium (<18 milliequivalents / liter), normal urinary sediment and autopsy kidney disease. Functional renal failure and liver necrosis causes, treatment and liver function tests has nothing to do. Furosemide and mannitol are no effect, of which 3 cases of urine output increased, but the blood