新生儿学教学课件 Acute Glomerulonephritis.pptVIP

Treatment 急性肾衰 争取时间以利肾功能恢复 1、去除病因 2、防止并发症的发生 3、少尿期严格控制液体入量：液体入量= 前一天尿量+显性失水+不显性失水-内生水量 4、纠正水电解质紊乱 5、透析疗法 Acute Glomerulonephritis Anatomical ，Physiological Classification Overview Etiology Pathogenesis ，pathology Manifestations Laboratory test Diagnosis Treatment Prevention 预后与病因.病理改变有关 早期治疗可降低急性期死亡率。病毒感染及链球菌感染后肾炎预后好；多无复发   预防链球菌感染;发生链球菌感染应彻底治疗,并于感染后2—3周内随访尿常规 Prevention 教学目标 掌握： 1.急性肾小球肾炎的临床表现及实验室检查 2.急性肾小球肾炎的诊断及治疗 熟悉 急性肾小球肾炎的病因、发病机理及病理改变 了解 1.小儿泌尿系统的解剖生理特点 。 2.急性肾小球肾炎的鉴别诊断。 * * * * I have mentioned(提到) preceding infection previously(先前). Let’s make a short review.(简短回顾一下) Acute poststreptococcal glomerulonephritis (APSGN) follows throat’s or skin’s infections by certain nephritogenic strains of group A beta- hemolytic streptococci, * Most patients have edema resulting from water-sodium retention. The edema is usually not apparent and often presents palpebra swelling in the morning. * 50-70% of the patients have gross hematuria, which has a unique color and is described as smoky or tea-colored urine. Some of the patients have microscopic hematuria. The acute phase generally resolves within 2 months after onset, but urinary abnormalities may persist for more than 1 year. * * * Some patients may have varying degree of oliguria. Previously, while introducing the pathogenesis of acute glomerulonephritis, I have said glomerulotubular unbalance can result in oliguria. This table has listed the normal (正常) urine volume during various childhood period. * Other symptoms such as low-grade fever, abdominal pain, anorexia, vomiting, and headache could also exist. These symptoms are nonspecific, because many patients suffering from other kinds of diseases instead of APSGN (罹患非APSGN 疾病的患者) could have similar symptoms. * In addition, I would like to introduce acute nephritis complications. Early phase of acute nephritis in children may have three potential complications. The first one is serious circulation congestion that could even lead to cardiac