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目的 探讨闭合性肾损伤的诊断及治疗.方法 回顾分析了7003年1月至2008年2月共收治闭合性肾损伤患者142例.结果 闭合性肾损伤患者治愈136例,其中保守治疗124例,肾修补2例,肾切除8例,选择性肾动脉栓塞治疗2例.死亡6例.结论 CT可准确进行伤情评估,对治疗方案有指导作用.严格掌握保守治疗和手术指征,预防并发症的发生.  相似文献   

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Renal failure is a common complication of pancreatitis. To better understand this association, renal function was evaluated in eleven patients in the acute phase of alcoholic pancreatitis and again during convalescence in seven patients. Parameters measured included glomerular filtration rate, effective renal plasma flow, true renal plasma flow, renal vascular resistance, osmolar clearance, amylase clearance, renal oxygen consumption, cardiac output, and peripheral resistance.Average glomerular filtration rate, effective renal plasma flow, and true renal plasma flow were decreased in the acute phase. Osmolar clearance, amylase clearance, mean arterial blood pressure, renal vascular resistance, and total peripheral resistance rose in the acute phase. Cardiac index and extracellular fluid space remained normal. All parameters returned toward normal with convalescence.The combination of systemic hypertension, increased total peripheral resistance and renal vascular resistance, and normal extracellular fluid space suggests a release of a vasopressor during the acute phase of pancreatitis. The therapeutic implications of these findings including the role of vasodilator infusion are discussed.  相似文献   

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Introduction

Between January 2013 and September 2015, 135 consecutive renal transplant patients were screened prospectively with ultrasound for renal cell carcinoma (RCC).

Results

Eighteen ultrasound abnormalities were identified with 4 solid lesions detected. Fifty-six other patients were screened retrospectively by referring nephrology groups, with 6 additional malignancies found.

Conclusion

As a result of our data, we recommend and have instituted annual ultrasound screening of native kidneys in all renal transplant patients.  相似文献   

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Shunt nephritis is an immune-complex mediated glomerular disease associated with chronically infected ventriculo-jugular shunts for hydrocephalus. In general, early diagnosis and appropriate antibiotic therapy result in marked improvement or disappearance of the concomitant urinary and renal functional abnormalities. We describe a child in whom the diagnosis and treatment were delayed until she presented with irreversible renal insufficiency. We conclude that shunt nephritis is not an innocuous condition and that a high level of suspicion must be maintained by those caring for children with ventriculo-jugular shunts.  相似文献   

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Background

There is considerable controversy over the benefits of renin-angiotensin system (RAS) blockade in renal transplant recipients (RTRs). The aim of the study was to research the effects of RAS blockade on allograft and patient outcome.

Methods

A retrospective analysis of the effects of RAS blockade on allograft and patient outcome in 53 pairs of RTRs receiving grafts from the same donor was performed. The 106 RTRs (53 pairs), transplanted from 2002 to 2012, were included in the study when 1 patient from the pair used an angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) for a minimum period of 36 months (RAS[+]) and the second one did not use it (RAS[?]).

Results

There were no differences between RAS(+) and RAS(?) subjects in terms of age, body mass index, reason of end-stage renal disease, mismatches number, total ischemic time, episodes of cytomegalovirus infections, acute rejections, and immunosuppressive treatment. The mean time of observations was 66.28 months ± 24.39 months. RAS inhibitors were given in a mean dose of 23.1% (ACEI) and 27.08% (ARB) of the maximum recommended. The main reasons for the therapy were as follows: hypertension (39.62%), nephroprotection/proteinuria (39.62%), and polyglobulia (28.3%). The composite cardiorenal endpoint was reached by 6 (11.32%) and 7 (13.21%) patients in RAS(+) and RAS(?) group, respectively. There were no differences in changes of creatinine, potassium serum level, or estimated glomerular filtration rate between RAS(+) and RAS(?) patients in the early period after RAS blockade commencement.

Conclusion

Agents inhibiting the RAS system neither improved nor deteriorated patients and graft survival in RTRs.  相似文献   

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