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目的:探讨挤压综合征患者治疗进程中尿量变化与肾脏血流阻力指数改变的相关性及其意义。方法:监测9例地震伤挤压综合征患者在以连续性肾脏替代治疗(CRRT)为主的综合性治疗进程中不同时相点的尿量变化,同时利用彩超观测其相应时相点的肾脏血流阻力指数改变,分析少尿期、多尿期患者尿量变化与肾脏血流阻力指数改变之间的相关性。结果:挤压综合征患者CRRT治疗进程中尿量变化呈现为由少尿、无尿到多尿,最后到尿量平稳的过程,肾血流阻力指数表现为由高阻到阻力下降,最后到正常血流阻力的变化特点,少尿期、多尿期日尿量变化与肾脏血流阻力指数改变之间呈负相关(r=-0.91,P<0.01)。结论:挤压综合征患者CRRT治疗进程中少尿期、多尿期尿量变化与肾脏血流阻力指数改变之间具有很好的相关性,提示超声监测肾脏血流阻力指数变化可作为评价疗效及判断预后的较敏感、客观、便捷指标之一。
Objective: To investigate the relationship between changes of urinary output and change of renal blood flow resistance index in patients with crush syndrome and its significance. Methods: Nine patients with traumatic stress crush syndrome were enrolled in this study. The changes of urinary volume at different time points during the comprehensive treatment of continuous renal replacement therapy (CRRT) were monitored. The kidneys at the corresponding time points Changes in blood flow resistance index, analysis of oliguria, polyuria in patients with changes in urine flow and renal resistance index changes between the blood flow. Results: The change of urine volume during CRRT treatment in patients with crush syndrome showed oliguria, anuria to polyuria, and finally to a stable urine output. The index of renal blood flow resistance decreased from high resistance to resistance, and finally The changes of normal blood flow resistance characteristics, oliguria period, polyuria day urine volume changes and renal blood flow resistance index was negatively correlated (r = -0.91, P <0.01). Conclusion: There is a good correlation between changes of urinary volume in oliguria and polyuria during the course of CRRT in patients with crush syndrome and the change of renal blood flow resistance index, which suggests that the change of renal blood flow resistance index by ultrasound can be used as the evaluation of curative effect And to determine the prognosis of the more sensitive, objective and convenient indicators.