肾内科实习知识小结（Brief summary of practice knowledge of Nephrology）.doc

肾内科实习知识小结（Brief summary of practice knowledge of Nephrology） Kidney surgery practice summary.Txt like me, this is revolutionary need, know?! You cant fold your clothes while you stay! Ill fold it later! I must give you happiness, who do not want to stop. Brief summary of practice knowledge of Nephrology 1. definition of hemodialysis disequilibrium syndrome A clinical syndrome characterized mainly by neuropsychiatric symptoms during dialysis or shortly after dialysis. Light only anxiety, headache, accompanied by nausea and vomiting, blurred vision, widened pulse pressure and heart rate decrease the symptoms of intracranial hypertension; moderate with tremor, myoclonus, disorientation, lethargy and other symptoms; severe manifestation of epileptic seizures, coma and even death. The pathogenesis is not completely understood, is thought to be mainly due to the blood retention, metabolites removal too fast, cerebrospinal fluid (with urea as the solute concentration decreased relatively slowly, prominent) form a concentration gradient, causing water to spread to the brain, produced by cerebral edema and intracranial hypertension is a clinical syndrome, also known as the urea transfer hypothesis. Because the acidosis was quickly corrected, so that the blood PCO2 increased, which can be rapidly dispersed into the cerebrospinal fluid, and HCO3- mobile is relatively slow, resulting in blood and acidosis were corrected but increased acidosis in the brain, which may aggravate brain edema. In addition, there are many hypotheses such as glucose transfer, osmotic concentration, and so on. Clinically, this syndrome is most common in patients with severe hypoxemia and acidosis who have just been treated with hemodialysis. This disease should be associated with hypertensive encephalopathy, dural hematoma cavity, cerebrovascular accident, dialysis and hypercalcemia syndrome identification of hard water. The patients can be treated with hypertonic solution, intravenous injection and sy