62例重型颅脑损伤并发急性肾功能损害原因分析

目的　探讨重型颅脑损伤并发急性肾功能损害的原因。方法　回顾性分析 62例重型颅脑损伤并发急性肾功能损害的病因与处理。结果　神经源性肾功能损害 8例 ,肾前性因素 10例 ,多器官功能不全 6例 ,甘露醇性肾功能损害 3 8例 ,老年人占3 9例。本组病例经过适当处理有 46例肾功能恢复 ,9例基本恢复 ,7例无效。 16例死亡病例中有 6例死于多器官功能不全 ,10例死于重型颅脑损伤所致的脑疝。结论　重型颅脑损伤并发急性肾功能损害老年人多见 ,甘露醇性肾功能损害最常见 ,且与甘露醇用量有关。医源性因素致急性肾功能损害 ,应引起足够注意

Analysis of Causative Factors of severe Traumatic Brain Injury Complicated Acute Renal Function Insufficiency: A Report of 62 Cases

Objective To investigate the causes of severe traumatic brain injury (TBI) complicated acute renal function insufficiency. Methods The causes and the treatment of 62 cases of the severe TBI complicated acute renal function insufficiency was analyzed retrospectively. Results In all the 62 cases, 8 cases were neurogenic renal function insufficiency, 10 cases were prerenal, 6 cases were caused by multi-organ function failure, and 38 cases were caused by mannitol. 39 patients were elder. Through the suitable treatment the renal function of 46 cases recovered thoroughly; 9 cases recovered on the whole; 7 cases were ineffective. Among the 16 died cases, 6 cases died of multi-organ function failure and 10 cases died of the hernia of brain. Conclusions Severe TBI complicated acute renal function insufficiency is more often happened among the elders. The primary cause of renal function insufficiency is the mannitol, and it relates to the dosage of the mannitol. More attention should be paid to the iatrogenic acute renal function insufficiency.