Crushsyndrome压迫症候群.ppt
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Crushsyndrome压迫症候群.ppt

Crushsyndrome压迫症候群.ppt

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Bombings,earthquakes,buildingcollapse,trainaccidentsandminingaccidents.Crushinjuriesmayresultinfatalinjuryorseveremetabolicabnormalitiesthatmayresultindeath.Carefulmonitoringofthesepatientsisessential.定義肌肉承受缺血限度症狀腔室症候群致病機轉(1)致病機轉(2)致病機轉(3)致病機轉(4)致病機轉(5)致病機轉(6)致病機轉(7)休克機轉腎衰竭的機轉診斷原則(Criteria)Emergency!CrushSyndrome建議急救流程(1)建議急救流程(2)建議急救流程(3)ActionsofMannitolintheProphylaxisofPost-traumaticAcuteRenalFailure(1)Renal:Decreaseinbloodviscosity&oncoticpressureacrosstheglomerulus,causinganincreaseinglomerularfiltrationrateDilationofglomerularcapillariesandstimulationofprostaglandinEandIreleaseIncreaseinproximalintratubularpressureandflowandpreventionofobstructionPossiblereductionoftubularcellswellingandinjuryScavengingofoxygenfreeradicalsDangers:HyperosmolarvolumeoverloadinoligoanuriaMassiveIVdosesofmannitol(>200g/d)havebeenreportedtocauseacuterenalfailure;thistypeofARFispromptlyreversibleafterhemodialysis治療腔室症候群的建議預後結論