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学科主题泌尿外科学
急性肾梗死的病因分析及诊疗策略
其他题名Analysis of the etiology, strategy of diagnosis and treatment of acute renal infarction
张洪宪; 马潞林; 何为; 侯小飞; 刘磊; 赵磊
关键词急性肾梗死 病因 诊断 治疗 Acute renal infarction Etiology Diagnosis Treatment
刊名中华临床医师杂志(电子版)
2015
DOI10.3877/cma.j.issn.1674-0785.2015.16.008
16页:3010-3014
文章类型Journal Article
摘要目的:分析急性肾梗死(ARI)的临床病例特点、治疗方法和效果,探讨ARI的病因及诊疗策略。方法回顾分析北京大学第三医院2012年3月至2015年3月在急诊诊断为ARI的32例患者的临床表现、辅助检查、治疗和预后等资料。结果32例患者引起 ARI 的病因主要为:恶性肿瘤史(18.7%)、动脉粥样硬化(15.6%)和心脏性因素(9.4%);最常见的部位为左肾上极;最常见的症状和体征是腰痛(84.4%)和肾区叩痛(93.8%);常见的实验室检查异常是血中性粒细胞百分比水平升高(71.9%),血乳酸脱氢酶水平升高(71.9%),蛋白尿(75.0%),尿潜血(65.6%)。32例患者均具有典型的ARI的腹部增强CT表现,从初诊到腹部增强CT检查确诊ARI的平均时间为(6.34±4.55)h。所有患者均接受低分子肝素抗凝治疗和(或)介入治疗,全部患者出院时临床症状均有所改善。结论 ARI无明确病因,由于其发病率低,临床表现和实验室检查缺乏特异性,极易误诊。早期诊断依赖及时的腹部增强CT检查。抗凝治疗和(或)介入治疗对患者均可获益。 Objective To investigate the etiology and treatment strategy of acute renal infarction by analyzing the clinical characteristics, treatment and prognosis of patients with acute renal infarction. Methods We retrospectively reviewed the medical records of 32 patients diagnosed as acute renal infarction from March 2012 to March 2015 at Peking University Third Hospital. Results Among the 32 patients with acute renal infarction the most common causes were history of malignancy (18.7%), atherosclerosis (15.6%) and cardiogenic (9.4%). The most common locations of the acute renal infarction was upper pole of the left kidney. The common symptoms and signs included Lumbago (84.4%) and renal pain (93.8%). The common abnormalities in laboratory tests included elevated N%(71.9%), elevated LDH (71.9%), proteinuria (75.0%) and hematuria (65.6%). Typical enhanced CT manifestations appeared in all the 32 cases of patients with acute renal infarction. The time from presentation to receiving computer tomography examination was (6.34±4.55)h. All the patients received anticoagnlation and (or) interventional therapy, and symptoms were relieved in all the patients. Conclusion Without a clear etiology, the diagnosis of acute renal infarction is often delayed or unrecognized because of its non-specific presentation and the rarity of the disease. The early diagnosis of acute renal infarction needs timely abdominal enhanced CT examination in the emergency department. Anticoagulant therapy and (or) intervention therapy is beneficial.
语种中文
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文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/72424
专题北京大学第三临床医学院_泌尿外科
作者单位1.100191,北京大学第三医院泌尿外科
2.100191,北京大学第三医院放射科
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GB/T 7714
张洪宪,马潞林,何为,等. 急性肾梗死的病因分析及诊疗策略[J]. 中华临床医师杂志(电子版),2015(16):3010-3014.
APA 张洪宪,马潞林,何为,侯小飞,刘磊,&赵磊.(2015).急性肾梗死的病因分析及诊疗策略.中华临床医师杂志(电子版)(16),3010-3014.
MLA 张洪宪,et al."急性肾梗死的病因分析及诊疗策略".中华临床医师杂志(电子版) .16(2015):3010-3014.
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