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目的探讨严重创伤后休克并发肝、肾功能障碍的治疗及机制。方法对4例严重创伤的休克患者同时并发肝、肾功能障碍的原因与治疗方法进行分析。结果在抗休克及治疗原发疾病的前提下,4例肝、肾功能障碍患者经治疗后期肝、肾功能均得到恢复。结论肾、功能障碍患者早期往往表现为急性肾功能衰竭(ARF),而肝功能障碍早期表现不明显,待肝储备耗竭才表现出来。它们有共同的发病机制:肝肾细胞缺血缺氧;再灌注后氧自由基引起肝肾损害;代谢产物、代谢障碍引起肝、肾功能障碍。治疗上依靠维持氧供、早期肠道营养、保肝利尿和综合治疗方法。
Objective To investigate the treatment and mechanism of severe traumatic shock complicated with liver and kidney dysfunction. Methods Four cases of severe traumatic shock in patients with concurrent liver and kidney dysfunction causes and treatment methods were analyzed. Results In the anti-shock and the treatment of primary disease under the premise of 4 cases of liver and kidney dysfunction in the late treatment of liver and kidney function were restored. Conclusions Renal and dysfunction patients often manifest acute renal failure (ARF) in the early stage, while liver dysfunction is not obvious in the early stage. They have a common pathogenesis: liver and kidney cell ischemia and hypoxia; oxygen free radicals cause liver and kidney damage after reperfusion; metabolites, metabolic disorders cause liver and kidney dysfunction. Treatment depends on the maintenance of oxygen supply, early intestinal nutrition, liver protection and diuretic and comprehensive treatment.