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患者男性,23岁,大学生,因参加万米赛跑,最后百米冲刺时突然摔倒,昏迷不醒,血压8/0 kPa,到我院急诊,当日尿量800ml。至第二日尿量少于100ml/日,颜面、四肢浮肿。尿常规:蛋白+++,红血球+++,尿胆红素(-),血尿素氮22.8mml/L,肌酐776.4mmol/L,血气分析提示低氧血症,代酸。诊断:急性肾功能衰蝎。入院后维持水电解质平衡,纠正酸中毒及对症支持治疗,症状缓解,但患者仍无尿,继续间断血透治疗。共透析5次,15天以后,病人开始排尿,一月后痊愈出院. 讨论剧烈运动后引起肾衰的机理主要是:(1)交感神经兴奋,血中儿茶酸铵增加,致肾血液灌注量不足,肾小球基底膜受损,
Male patient, 23 years old, college student, due to participate in the 10000-meter race, the last 100 meters sprint suddenly fell unconscious, blood pressure 8/0 kPa, to our emergency room, the same day the amount of urine 800ml. The amount of urine to the second day less than 100ml / day, facial, limb edema. Urine: protein +++, red blood cells +++, urinary bilirubin (-), blood urea nitrogen 22.8mml / L, creatinine 776.4mmol / L, blood gas analysis suggests hypoxemia, acidosis. Diagnosis: Acute renal failure. After admission to maintain water and electrolyte balance, correct acidosis and symptomatic and supportive treatment, symptoms, but the patient is still no urine, continue interrupted hemodialysis treatment. A total of 5 dialysis, 15 days later, the patient began to urinate, discharged after January to discuss the mechanism of strenuous exercise caused by renal failure are: (1) sympathetic excitement, increased blood catechin, renal blood perfusion Insufficient amount of glomerular basement membrane damage,