發(fā)布時間：2018-06-10 19:08

  本文選題：重癥 + 多器官功能障礙綜合征(Multiple��； 參考：《南京大學》2014年碩士論文

【摘要】：目的多尿癥是ICU中的常見并發(fā)癥,我們最近在重癥患者中發(fā)現(xiàn)一種不同于既往常見病因的特殊類型的多尿,目前國內外缺少相關研究報道,本文研究重癥患者在病情逐漸好轉、病程進入恢復期時發(fā)生的多尿的臨床與治療特點。方法回顧分析2006年1月至2013年6月南京軍區(qū)南京總醫(yī)院ICU住院病程中發(fā)生多尿癥的患者臨床資料,排除診斷明確的藥物作用、腎臟疾病、內分泌和代謝疾病、容量負荷過高等常見因素導致多尿的病例,篩選出病程進入恢復期發(fā)生特發(fā)性多尿的病例,從這種多尿的臨床表現(xiàn)、實驗室檢查及治療效果上研究這種特發(fā)性多尿的特點。結果共15例患者納入研究,入ICU后24小時急性生理與慢性健康評分(acute physiology and chroni c health evaluation,APACHE II)評分為(24.3±5.7)分,多尿發(fā)病后24小時評分為(16.1±5.5)分；入監(jiān)護后13-27天發(fā)生多尿,多尿持續(xù)時間為(22.3±9.6)d,尿量高峰時可達(81±17)mL.(Kg·d);多尿發(fā)病時血肌酐(101±22)μmol/L、血鉀(2.7±0.4)mmol/L且尿比重偏低。其中6例以垂體后葉素(Pituitrin)治療的患者尿量明顯減少。15例全部治愈。結論重癥患者在病情趨于穩(wěn)定后出現(xiàn)的多尿與常見的腎衰多尿、滲透性利尿(osmotic diuresis).尿崩癥(diabetes insipidus, DI)等多尿不同；使用垂體后葉素治療特發(fā)性多尿可明顯降低尿量；垂體后葉素不能縮減特發(fā)性多尿的病程,但有利于控制尿量及維持內穩(wěn)態(tài)平衡。
[Abstract]:Objective Polyuria is a common complication in ICU. We have recently found a special type of polyuria in severe patients, which is different from the common etiology in the past. At present, there is no relevant research report at home and abroad. The clinical and therapeutic characteristics of polyuria in the course of convalescence. Methods from January 2006 to June 2013, the clinical data of patients with polyuria in ICU of Nanjing General Hospital of Nanjing military region were retrospectively analyzed, and the diagnosis of drug action, kidney disease, endocrine and metabolic diseases were excluded. Cases with polyuria caused by high volume load and other common factors were screened out. The characteristics of idiopathic polyuria were studied from the clinical manifestation, laboratory examination and therapeutic effect. Results A total of 15 patients were enrolled in the study. The acute physiology and chroni c health evaluation and Apache II scores were 24.3 鹵5.7, 16.1 鹵5.5 and 16.1 鹵5.5, respectively. The duration of polyuria was 22. 3 鹵9. 6 渭 mol 路L ~ (-1), the peak of urine volume was 81 鹵17? M 路L 路g / d, the serum creatinine was 101 鹵22 渭 mol / L, the serum potassium was 2.7 鹵0. 4 渭 mol / L and the urine specific gravity was low at the time of onset of polyuria. Of the 6 patients treated with Pituitrinin, the urine volume was significantly decreased. 15 cases were cured. Conclusion the polyuria and the common renal failure polyuria, osmotic diuresis, were found in severe patients after their condition became stable. Diabetes insipidus (DI) is different from diabetes insipidus, the treatment of idiopathic polyuria with pituitrin can significantly reduce the urine volume, and the course of idiopathic polyuria can not be reduced by pituitrin, but it is helpful to control urine volume and maintain homeostasis.
【學位授予單位】：南京大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R694.5

【共引文獻】

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本文編號：2004288