一例犬急性腎衰的诊治.docVIP

一例犬急性肾功能衰竭的诊断与治疗 袁冬梅 （2012届动物医学专业3班） 摘要：急性肾功能衰竭(Acute Renal Failure，ARF，简称急性肾衰)，指的是某一急性的伤害导致肾脏功能快速进行性丧失。在动物医院实习期间接诊了一例犬患急性肾衰竭的病例，通过一般检查、血常规和生化检查，最后确诊为急性肾功能衰竭，疑似为前期治疗胃肠疾病用药所导致。但因就诊时间过晚，病情严重，最终治疗无效死亡。本文就患犬的临床诊断、实验室诊断及相关治疗进行论述，并着重分析讨论造成该病的病因，针对治疗方法及临床用药提出建议，希望对动物肾功能衰竭的诊疗提供一些参考。 关键词：急性肾衰竭；犬；用药；检查；治疗；病因 The Diagnosis and Treatment of One Case of Acute Renal Failure in Dog Yuan Dong-mei (Class 3 of the Veterinary Medicine, Graduated in 2012) Abstract: Acute renal failure (Acute Renal Failure ARF, referred to as acute renal failure), referring to a rapid kidney function loss which is caused by an acute injury in kidney. During the internship at the Animal Hospital, one case of dogs suffering from acute renal failure was received.Through the general examination, the dog’s clinical symptoms and blood and biochemical tests, it was diagnosed as acute renal failure.It is suspected to be caused by pre-treatment of gastrointestinal disease medication. Because it was too late to the hospital and the condition was very poor, eventually the dog died. In this paper, the dogs clinical and laboratory diagnosis and all treatments related are discussed. The cause of the disease was focused, and some advices on therapies and clinical medicine about Acute Renal Failure were provided . Key words: Acute Renal Failure;dogs; medicine; Diagnosis; Treatment; cause of the disease 急性肾衰竭是由各种致病原因造成两肾排泄功能在短期内迅速减退，肾小球滤过功能下降，血尿素及血肌酐迅速升高，并引起水、电解质及酸碱平衡失调及急性尿毒症等的综合症状现象［1］。可能的病因分为肾前性、肾后性、毒素或传染性的病原直接损害肾脏而造成（肾源性）。急性肾衰竭的发病机理中肾血流灌注不足起重要作用。肾缺血使肾小管损伤和功能障碍，肾小管损伤又促使肾小球缺血加重，形成恶性循环。肾缺血、肾小管坏死和肾小管阻塞等因素造成肾小球率过滤降低和泌尿功能障碍，导致机体发生氮质血症、代谢性酸中毒和高钾血症等代谢和功能变化。 兽医临床中许多疾病的后期均可引起动物发生本综合症，即使进行救治，病死率仍然高达60%以上。若能做到早诊断、抢救及时、恰当，则可使肾恢复正常并明显减少动物的死亡率［2］。本文通过对一例临床表现为剧烈呕吐、食欲不振、无尿的患犬进行了一般检查和实验室检查，确诊为急性肾衰竭的病例进行了论述，期望通过对该病例的论述，为临床急性肾衰的诊断和治疗提供参考素材。 1 材料与方法 2012年2月，于东风路河南农业大学附属动物医院。 1.2 实验动物 金毛犬雄性6月龄，11.45kg，体温38℃。主诉：1.3 主要器械与药物 1.3.1 使用仪器IDEXX，VetTestmindray,BC-2800Vet）1.3.2 治疗用药物1.4 检查方法 1.4.1 通过体温检查、视诊、触诊等常规的方法检查患犬。1.4.2 实验室检