CAJ | 학술논문

目的探讨严重创伤后休克并发肝、肾功能障碍的治疗及机制.方法对4例严重创伤的休克患者同时并发肝、肾功能障碍的原因与治疗方法进行分析.结果在抗休克及治疗原发疾病的前提下,4例肝、肾功能障碍患者经治疗后期肝、肾功能均得到恢复.结论肾、功能障碍患者早期往往表现为急性肾功能衰竭(ARF),而肝功能障碍早期表现不明显,待肝储备耗竭才表现出来.它们有共同的发病机制:肝肾细胞缺血缺氧;再灌注后氧自由基引起肝肾损害;代谢产物、代谢障碍引起肝、肾功能障碍.治疗上依靠维持氧供、早期肠道营养、保肝利尿和综合治疗方法.
목적 탐토엄중창상후휴극병발간、신공능장애적치료급궤제.방법 대4례엄중창상적휴극환자동시병발간、신공능장애적원인여치료방법진행분석.결과 재항휴극급치료원발질병적전제하,4례간、신공능장애환자경치료후기간、신공능균득도회복.결론 신、공능장애환자조기왕왕표현위급성신공능쇠갈(ARF),이간공능장애조기표현불명현,대간저비모갈재표현출래.타문유공동적발병궤제:간신세포결혈결양;재관주후양자유기인기간신손해;대사산물、대사장애인기간、신공능장애.치료상의고유지양공、조기장도영양、보간이뇨화종합치료방법.
Objective To investigate the treatment and pathigenesis of liver and renal disfunction caused by severe trauma with shock.Methods The treatment and pathigenesis were analyzed for four patients with liver and renal disfunction caused by severe trauma with shock. Results On the basis of antishock and treatment for primary disease, all of the four patients recovered after treatment for liver and renal disfunction. Conclusion Acute renal failure (ARF) was the early manifestation of renal disfuntion usually,but the early manifestation of liver disfuntion was not obvious and it could be displayed only until the reserve of liver was exhausted. The identical pathogenesis of liver and renal disfunction caused by severe trauma with shock were as follows: liver cells and renal cells suffer from hypoxia; liver and renal damage caused by oxygen-derived free radicals after reperfusion; liver and renal damage caused by metabolic products and metabolic disfunction. The treatments include ventilation, early enteral nutrition, liver protection, diuresis and combined therapy.