Of acute renal failure surgical treatment.docVIP

 PAGE \* MERGEFORMAT 8 Of acute renal failure surgical treatment [Keywords:] acute renal failure dialysis efficacy Acute renal failure (ARF) refers to various causes of acute renal damage, and the resulting mass of nitrogen in the blood caused by the accumulation of metabolic products and water and electrolyte, acid-base balance and a series of pathophysiological changes. (A) history 1. Prerenal ARF due to effective hypovolemia to reduced renal perfusion pressure, glomerular filtration rate, for reasons including: 2. Renal ARF due to renal ischemia, lead poisoning, renal damage, often acute tubular necrosis. 3. After the pieces of renal ARF. (B) Clinical manifestations 1. Oliguria or anuria period (7 to 14 days) adult 24-hour urine output of less than 400 ml, said oliguria, adult 24-hour urine output less than 100 ml, said no urine. (1) water-electrolyte and acid-base balance 1) water intoxication: the body of water accumulation caused by high blood pressure, heart failure, pulmonary edema, cerebral edema, clinical manifestations are nausea, vomiting, headache, drowsiness, convulsions, and coma. 2) metabolic acidosis: chest tightness, shortness of breath, nausea, vomiting, drowsiness, coma, blood pressure, arrhythmia, cardiac arrest. 3) hyperkalemia, hypermagnesemia: two parallel rise, hyperkalemia can occur agitation, drowsiness, reduced muscle tension, bradycardia, arrhythmia and even cardiac arrest, electrocardiogram T wave height showed sharp , QRS widening waves, S waves and blue. hypermagnesemia have neurological symptoms such as reduced muscle strength, tendon reflexes. 4), hypocalcemia, hyperphosphatemia: convulsions. 5), hyponatremia, low chlorine hyperlipidemia: sodium, chlorine ratio of water intoxication have lost or diluted sodium, low chloride acidosis, appear indifferent, dizziness, severe cerebral edema and hypotonic produce coma. (2) the accumulation of metabolic products, there