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严重烧伤时,肾脏均有不同程度的损害,但发展至急性肾功衰竭者较少。然而,急性肾衰一旦发生,处理极为困难,预后非常险恶。 Davies(1979)报导应用血液透析或腹膜透析法处理28例烧伤合并急性肾衰病人,仅有4例肾功能得到恢复,其中2例以后又分别死于败血症、肝功衰竭及中毒性心肌炎。该氏又收集文献报导的6062例烧伤,其中合并急性肾衰者95例,仅有4例存活。现今由于抗休克措施的不断改进,大面积烧伤病人绝大多数能平稳地渡过休克期,因而感染、代谢异常及各主要脏器的衰竭(如肾衰、心衰、急性肺功能不全)等已成为死亡的主要原因。
Severe burns, the kidneys have varying degrees of damage, but less developed to acute renal failure. However, once acute renal failure occurs, the treatment is extremely difficult and the prognosis is very dangerous. Davies (1979) reported that hemodialysis or peritoneal dialysis was used to treat 28 patients with burn-related acute renal failure. Only 4 patients recovered their renal function. Two of them subsequently died of sepsis, liver failure and toxic myocarditis, respectively. The collection of literature and reported that 6062 cases of burn, of which 95 cases of acute renal failure, only 4 survived. Due to the continuous improvement of anti-shock measures, the overwhelming majority of patients with extensive burn can smoothly pass the shock period, so the infection, abnormal metabolism and the failure of major organs (such as renal failure, heart failure, acute lung insufficiency), etc. Has become the main cause of death.