肾功能障碍病人的麻醉（Anesthesia in patients with renal dysfunction）.docVIP

肾功能障碍病人的麻醉（Anesthesia in patients with renal dysfunction） According to the etiology, renal dysfunction can be divided into the anterior renal type, the renal type and the posterior renal type. The disease can be divided into acute and chronic according to the course of disease. Renal failure is essentially the same as renal failure, but only in a different degree. Renal failure refers to renal insufficiency and late renal insufficiency disease from mild to cover the whole process, the weight, which includes both the multiple organ dysfunction caused by renal dysfunction, including adaptive compensatory responses to anti injury. First, kidney, urinary tract obstruction, cirrhosis and other kidney function changes The pathological changes of renal function caused by different etiology are different. Renal biopsy pathological examination showed that the main pathological renal pathology of renal patients decreased as follows: renal interstitial microvascular total area reduced; microscopic rare tubular epidermal cells especially the ascending loop of Henle, due to ischemia and renal interstitial fibrosis and atrophy. As a result, renal dysfunction, osmotic pressure gradient is difficult to maintain, prone to water retention. Glomerular invasion, microvascular stenosis, and even obstruction can lead to reduced glomerular blood supply, and hence decreased glomerular filtration rate. Dysfunction of kidney concentrating urine indicates impaired unit function. Renal pathology showed no correlation between the severity of renal hyaline degeneration and the change in urine osmolality. The ability of kidneys to lose concentrated urine when chronic kidney disease is reduced due to reduced glomerular filtration rate without polyuria. The hemodynamic changes of the glomerulus are closely related to the hemodynamic changes of the renal tubules. After acute ureteral obstruction, transient renal blood flow increases, and then progressive vasoconstriction results in increased resista