14泌尿科（14 urology）.docVIP

14泌尿科（14 urology） Two urology: (1) urine volume: 24 hours urine volume in adults. 400ml is called oliguria. 24 hours urine volume (100ml) is called no urine. (two) pre renal acute renal failure The concept of pre renal acute renal failure: decreased renal perfusion leads to decreased glomerular filtration rate mediated by hemodynamics. If the amount of renal perfusion can be corrected in time, the hemodynamic impairment can be reversed, and the renal function will recover rapidly, but there is no damage to the renal parenchyma. If the hypoperfusion continues, the cells may become markedly damaged and turn from anterior renal to acute renal tubular necrosis (ATN). Acute renal failure concept: acute renal damage caused by various causes, and accumulation of nitrogenous metabolites in the blood, as well as a series of pathophysiological changes such as water, electrolyte and acid-base imbalance. The obvious decrease in urine is the most obvious sign of impaired renal function. Etiology of renal insufficiency: 1 effective blood volume deficiency is common in gastrointestinal fluid loss; use diuretics, extensive burns, hypoproteinemia, etc.. 2 heart failure is found in cardiomyopathy, cardiac valve dysfunction, pericardial tamponade, etc.. 3, systemic vascular dilatation, in sepsis, allergic reactions, anesthesia, accidents, etc.. 4 renal artery constriction leads to renal ischemia Treatment： In the case of dehydration, prerenal oliguria is mainly caused by the loss of liquid, when rapid rehydration, insufficient liquid can make the renal hemodynamics worsen, will eventually lead to renal tubule degeneration (ATN). This solution has replenished, but less urine persists when available vasopressor therapy in septic shock caused by cardiogenic shock or hypotension, vasopressor drugs should be used to maintain blood pressure and protect the renal blood flow and renal function, dopamine per minute 1 ~ 5 g/kg, can increase renal blood flow without causing systemic changes bloo