| 小儿心脏术后并发急性肾衰竭的防治策略 |
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| 引用本文： | 周智恩,邓硕曾,何伦德,孙小圣,张琴,廖大成.小儿心脏术后并发急性肾衰竭的防治策略[J].四川医学,2009,30(10):1592-1594. |
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| 作者姓名： | 周智恩 邓硕曾 何伦德 孙小圣 张琴 廖大成 |
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| 作者单位： | 1. 成都心血管病医院心外科,四川,成都,610031
2. 四川大学华西医院麻醉科,四川,成都,610041 |
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| 摘 要： | 目的总结小儿心脏术后并发急性肾衰竭（ARF）的治疗对策。方法回顾分析2003年1月-2007年10月我院小儿心脏术后并发ARF患儿39例（4.8%）临床资料。患儿均实施根治术。术后除加强呼吸、循环等处理外,27例ARF常规治疗无效者行腹膜透析（PD）治疗。结果术后合并ARF患儿,院内死亡15例,病死率达38.4%（15/39）,死亡原因分别为早期严重低心排10例,感染并发多器官功能衰竭3例,心脏骤停1例,肺功脉高压危象1例。余24例均痊愈出院。结论保证循环稳定,减少异体血制品的输入,把握好PD时机是小儿心脏术后ARF防治的关键。
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| 关 键 词： | 肾衰竭 急性 心脏外科手术 术后处理 小儿 |
Therapeutic strategy for acute renal failure following cardiac surgery in childern |
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| Institution: | ZHOU Zhi-en ,DENG Shuo-zeng, HE Lun-de ,et al.( 1. Chengdu Cardiovascular Hospital, Chengdu, Sichuan 610031 ;2. West China Hospital ,Sichnan University, Chengdu ,Sichuan 610041 , China) |
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| Abstract: | Objective To summarize our experiences of therapeutic strategy for acute renal failure（ARF） following cardiac surgery in children. Methods To review 39 consecutive cases 25 male/14 female, mean age （ 4.20 ± 3.58 ） years, mean weight（ 12. 35±7.65kg] with ARF following cardiac surgery procedure for congenital heart defects from January 2003 to October 2007. The postoperative management included the respiratory and circulatory support, peritoneal dialysis（PD）. Results The hospital mortality rate of ARF was 38. 4% （15/39）. The main causes of death were early serious low cardiac output syndrome（8 cases） , multiple organ dysfunction syndrome （ MODS ） （ 5 cases ） , cardiac arrest （ 1 case ） and pulmonary hypertension crises （ 1 case）. Conclusion Maintaining circulation stable, reducing homoloyous transfusion, and the optimal opportunity of PD are the key to postoperative management for ARF. |
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| Keywords: | renal failurel acute cardiac surgery procedure postoperative management children |
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