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Obstructive jaundice clinical analysis of 650 cases

strointestEndosc, 1991,[link widoczny dla zalogowanych],37:31. 【4】 OttDJ, YungGP, MiteheH, eta1. ThompeutieERCP: spectrumofpcedurespreformedin60consecuitivePatients [J]. AbdomImasing, 1994,19:30. 【5】 Fujita direct filial piety. Diagnosis and treatment of biliary tract cancer】【J. Japanese Medicine, 1997,18 (11): 486. Received Date: 2O0r7-O4-24 dopamine and phentolamine treatment of pediatric acute renal failure 26 patients efficacy Baile Ping, Liu Yi Fei (Yima Coal City General Hospital Pediatrics justice, Henan Yima 472300) Article ID: 1009 - 5519 (2007) 15-2298-02 CLC number: R72 Document code: B acute renal failure is a syndrome due to various causes. Varied clinical manifestations, severity is not _, high mortality,[link widoczny dla zalogowanych], acute renal insufficiency in children is more hidden manifestations, treatment is more difficult. In order to observe dopamine and phentolamine in the treatment of pediatric acute renal failure results. Now in our hospital in January 2002 ~ December 2006 with dopamine and phentolamine treatment of 26 cases of acute renal failure as follows. l clinical data 1.1 General information: The group of 26 patients, 17 patients were male. 9 female; aged 5 to 13 years old, of which 7 patients aged 5 to 7 ,7-9 years in 16 patients. 9 to 13 years in 3 cases. 1.2 Diagnostic Criteria: According to the May 1993 Chinese Medical Science Society of Nephrology moment group developed the diagnostic criteria 『I1. 1.3 Clinical manifestations: 23 cases are in line with the above-mentioned diagnostic criteria, edema, oliguria in 20 cases. 2 cases of anuria, azotemia in 23 cases, hyperkalemia in 12 cases, 8 cases of hyponatremia, metabolic acidosis in 11 cases,[link widoczny dla zalogowanych], 8 cases of hypertension, 1 case of hypertensive encephalopathy,[link widoczny dla zalogowanych], pneumonia in 2 cases, the 1 case of toxic hepatitis. 1.4 causes: 21 cases of acute nephritis, 2 cases of drug poisoning. 3 cases of bee sting poisoning. 2 Treatment and outcome of 26 patients in the anti-inflammatory, rehydration, correction of electrolyte disorders on the basis of those with acute nephritis, dipyridamole, nifedipine, and (or) captopril; poisoning increase the dose of vitamin C,[link widoczny dla zalogowanych], energy mixture, while dopamine were 0.3 ~ 0.5mg / (kg · d) Phentolamine 0.2 plus. 3mg / (kg · d)} JIl furosemide 1-2mg / (kg · d), ~ JU. K5% glucose intravenously 1-3 days, urine output increased, normal urine furosemide disabled, continue with dopamine and phentolamine 5 to 20 days, 25 were cured and discharged. 1 case of urea nitrogen discharge 14mmol / L. After discharge from hospital to continue serving traditional Chinese medicine. 2 months after the review of the normal blood urea nitrogen. 3 Discussion 3.1 The group of acute renal failure are renal, in addition to drugs, poisoning, bee stings 5 exception. Than are kidney disease. Kidney disease caused by inflammation of the glomerular capillary basement membrane of luminal narrowing. Different severity of renal lesions, and poisoning caused by renal tubular epithelial cell necrosis. Tubular obstruction and tubular glomerular filtration after injury to the peritubular capillary passive reflux. May cause interstitial nephritis I2-1. Which led to renal insufficiency. 3.2 under normal circumstances. 99% of the original urine in the renal tubules is reabsorbed. Tubular reabsorption is the main reason of the final urine volume, furosemide on electrolyte and by reducing the tubular reabsorption of water play a role in 131. Patients with acute renal insufficiency of renal blood flow reduction. Decreased production of urine and cause of the original arrival tubular diuretics reduced, a Emotional dopamine renal tubular dopamine receptors directly, a small dose of excitement when the major blood vessels of the broad D receptor, through the protein to promote the formation of intracellular cAMP, cAMP and protein kinase A caused by blood vessel relaxation, in particular, expressed in kidney, kidney expandable blood vessels. The renal artery blood flow increases, the glomerular filtration rate increased natriuretic. Eliminate the 33 Phentolamine blocked the catecholamine effect on vascular smooth muscle contraction. To renal vasodilation. Increased renal perfusion, it venules 0 【receptor blocking effect of a small artery than on strong. Reduce capillary hydrostatic pressure, increased nutritional capillary perfusion and improve renal microcirculation leaving glomerular filtration rate increased. 3.4 As dopamine, phentolamine, furosemide combined effects of three drugs in patients with acute renal insufficiency can increase when the glomerular filtration rate, reduced renal tubular reabsorption.
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