机械通气与急性肾损伤  

Mechanical ventilation and acute kidney injury

作　　者：李青霖[1] 王小丹[1] Li Qinglin Wang Xiaodan.(Division of Health Care,South Building Clinical Department, Chinese PLA General Hospital, Beijing 100853, China)

机构地区：[1]解放军总医院南楼临床部保健科,北京100853

出　　处：《中华肾病研究电子杂志》2017年第4期186-189,共4页Chinese Journal of Kidney Disease Investigation（Electronic Edition）

基　　金：国家自然科学基金项目(81370452)

摘　　要：机械通气是临床治疗中的常用手段,但是机械通气同时又通过改变肾脏血流动力学、神经体液及呼气末正压作用等机制影响肾小球滤过功能,引起或促进AKI的发生发展。肾脏保护是机械通气患者临床诊治中一个不可忽视的问题。通气治疗过程中调整合理的呼吸机参数,注意对肾功能的保护,如控制感染时按照肾功能水平计算用药剂量和间隔时间、低血压状况时采用合适的血管活性药物提升血压等,以及肾脏专科医师的及时会诊均可以改善伴有AKI的机械通气患者的预后。Mechanical ventilation is commonly used in the clinical treatment. However,mechanical ventilation can also affect glomerular filtration function, and cause or promote the occurrence and development of AKI,through mechanisms of changing the renal hemodynamics,neurohumoral function,and positive end-expiratory pressure effect,etc. Renal protection is an issue that can not be ignored in clinical diagnosis and treatment of patients who receive mechanical ventilation. Measures are helpful for improving prognosis of patients receiving mechanical ventilation and complicated with AKI, such as reasonable adjustment of ventilator parameters in ventilation treatment process,and paying attention to protection of renal function by infection control with proper calculation of dose and time interval according to the level of renal function,hypotension management with suitable vasoactive drugs to increase blood pressure,as well as timely consultation with nephrologists.

关 键 词：机械通气 急性肾损伤 危险因素 

分 类 号：R692.5[医药卫生—泌尿科学]