Urinary System泌尿系统全英文.pptVIP

Definition Treatment and prognosis of acute renal failure The principle of treatment Treatment of primary disease Treatment based on symptoms 1. Strictly control the liquid intake 2. Treatment of hyperkalemia 高钾血症 3. Correction of metabolic acidosis 代谢性酸中毒 4. Therapy of azotemia 氮质血症 5. Dialysis therapy 透析疗法 Treatment ⅠCorrect the reversible etiology, prevent additional damage: Active treatment of the primary disease, eliminate the factors that lead to or exacerbate(加重) ARF ； Quickly and accurately supplement the blood volume, maintain effective circulating blood volume enough； Prevent and correct low perfusion, avoid the use of nephrotoxic drugs。 Treatment Ⅱ Maintain fluid balance Fluid volume is equal to dominant fluid loss add non dominant fluid loss subtract the endogenous content 补液量＝显性失液量＋非显性失液量－内生水量 Estimating: the liquid feeding amount is equal to amount of urine add 500ml 估算：进液量＝尿量＋５００ml Treatment Ⅲ Diet and nutrition We should provide sufficient heat, thereby reducing to break down. protein. carbohydrate and fat Protein restriction is 0.8g / (kg ? d) As much as possible to reduce the intake of sodium(钠) , potassium(钾) and chloride(氯). Treatment Ⅳ Hyperkalemia （Hyperkalemia 6.5mmol / L, ECG abnormality） l0% calcium gluconate 10 ~ 20ml after dilution (IV 5 minutes) 5% sodium bicarbonate 100ml iv drop 50% glucose 50ml add 10U insulin iv drop slowly Oral: ion exchange resin交换树脂 Dialysis Treatment Ⅴ Metabolic acidosis (HCO3 15mmol / L) It can be treated with 5% sodium bicarbonate 100 ~ 250ml intravenous drip, Severe acidosis should be immediately treated by dialysis. Ⅵ Infection The early use of antibiotic According to the drug sensitive test , low nephrotoxic drugs should be chosen. Adjust the dosage according to endogenous creatinine clearance rate Treatment Ⅶ Heart failure The diuretic response is poor in patients with ARF Digitalis eff