应用超声心动图对慢性肾衰竭患者心脏结构和功能性损伤进行影像学评价。方法:选取本院2008年3月至2012年7月收治的54例慢性肾衰竭患者作为研究对象(肾衰竭组),另取54例正常者作为对照组。应用超声心动图检查慢性肾衰竭患者心脏功能指标,包括LAD、LVPWs、LVPWd、LVIDs、LVIDd、IVSTd、IVSTs、SV、EF等数据。将检查后所得数据进行比较,分析慢性肾衰竭患者的心脏结构和功能的损伤情况。结果:检查后的两组数据比较显示,肾衰竭组的LVPWs、LVPWd、IVSTd、IVSTs较对照组显著增加,具有统计学意义(P0.05)。在心脏功能性评价,SV、E、A较对照组明显较高,具有统计学意义(P0.05)。结论:慢性肾衰竭患者由于心脏病变导致心脏结构和功能发生特异性变化,通过超声心动图检查,对临床治疗指导具有重要意义。

To evaluate the application of echocardiography on cardiac structural and func-tional damage in patients with chronic renal failure .Method: 54 patients with chronic renal failure in our hospital from March 2008 to July 2012 were selected as the research object ( the renal failure group ) ,and 54 health cases for the control group .Application of echocardiography in patients with chronic renal failure to ex-amine heart function index,including the LAD, LVPWs, LVPWd, LVIDs, LVIDd, IVSTd, IVSTs data, SV, EF, etc.And compared the data after checking and analyzing the damage situation of cardiac structure and function in patients with chronic renal failure .Result: The data showed that the LVPWs , LVPWd, IVSTd,IVSTs of the renal failure group were significant increased than the control group ,it had statistically significant ( P<0.05) .The SV,E,A of the renal failure group were significantly higher than those of the con-trol group in the heart functional evaluation ,it had statistically si

探讨导致慢性肾衰竭急性加重的因素。方法:2009年1月-2013年1月收治慢性肾衰竭非透析患者50例,分为老年组28例和中青年组22例,均采用常规治疗。对导致慢性肾衰竭急性加重的诱发因素进行分析。结果:导致慢性肾衰竭急性加重的因素包括急性感染、肾毒性药物、血压急剧升高、急性左心衰、急性血容量不足、尿路梗阻及手术等。其中老年组以急性感染、肾毒性药物、急性左心衰、急性血容量不足多见;中青年组以血压急剧升高、肾毒性药物、急性感染多见。结论:慢性肾衰竭患者对一些促使肾功能急剧恶化的因素应及早防止和控制。

Objective:To explore the factors of chronic renal failure exacerbations.Methods: 50 cases with chronic renal failure but not dialysis were admitted from January 2009 to January 2013.They were divided into the elderly group with 28 cases and the young and middle-aged group with 22 cases.Adopt regular treatment.And then analyze the inducing factors of acute exacerbation of chronic renal failure.Results:Acute infection,nephrotoxic drugs,a sharp increase in blood pressure,acute left heart failure,acute hypovolemia,urinary tract obstruction and operation and other factors could cause exacerbations of chronic renal failure.The main factors of the elderly group were acute infection,nephrotoxic drugs, acute left heart failure and acute hypovolemia. The main factors of the young and middle-aged group were a sharp increase in blood pressure,nephrotoxic drugs and acute infection. Conclusion:In patients with chronic renal failure,some factors should be control to avoide prompting rapid deteriorati

目的：采用肾脏大小、髓质回声、血流灌注等多种超声参数的评分来探讨其在急性肾功能衰竭中诊断及与慢性肾功能衰竭鉴别诊断的价值。方法171例患者分成4组，即急性肾功能衰竭组、慢性肾功能衰竭组、肾功能正常的肾病组和正常对照组，观察4组患者的肾脏大小、形态（藕片征）、血流（烟花征）等指标，采用评分法，用ROC曲线下面积寻求一个最佳的诊断界值。结果肾皮质回声增强、髓质回声减低，形成藕片征是急性肾功能衰竭的特征性改变，能很好地对急性肾功能衰竭与慢性肾功能衰竭的患者进行鉴别；肾血流灌注虽与血肌酐呈负相关，但在急性肾功能衰竭和慢性肾功能衰竭仍有较大区别，急性肾功能衰竭者血流减少相对较轻多为1级和2级，表现为烟花征，而慢性肾功能衰竭多为3级和4级；肾脏增大为急性肾功能衰竭，缩小为慢性肾功能衰竭，正常大小鉴别无意义。对于非糖尿病的肾功能衰竭患者，综合评分≥10分，诊断为急性肾功能衰竭，敏感度83.7%，特异度95.6%。结论超声多参数分析，对于诊断急性肾功能衰竭尤其是肾脏大小正常患者有重要价值。

Objective To explore the values of scoring kidney size,medulla echo,blood perfusion and other ultrasound parameters in the differential diagnosis of acute and chronic kidney failure.Methods Forty-three cases of acute renal failure,forty-five cases of chronic renal failure,forty-three cases of kidney disease with normal renal function and forty cases of healthy controls were enrolled in this study.Size of kidney,form (lotus-root sign),blood flow (firework sign)and other indicators were observed and scored.Then,the scores of the parameters were used to draw ROC curve for seeking an optimal diagnostic cutoff.Results The renal cortex echo enhancement and medulla echo reduction,forming a lotus root sign,were characteristic changes of acute renal failure for distinguishing acute kidney failure from the chronic.Although blood perfusion in kidney was negatively correlated with creatinine in kidney failure,the reduction of blood flow showing as firework sign was mostly acute renal fai

目的：了解德州市慢性肾衰竭合并中枢神经系统损害的流行病学状况，提高对此病的临床诊疗水平。方法对我院慢性肾衰竭（CKD5期已行血液透析）合并中枢神经系统损害患者病例资料进行回顾性分析。结果德州市慢性肾衰竭中枢神经损害患者年龄、原发病、血肌酐、血尿素氮、血红蛋白、二氧化碳结合力、应用头孢菌素等与对照组有统计学差异（P<0.05）。结论糖尿病肾病、毒素水平高、贫血、代谢性酸中毒、应用头孢菌素等是德州市慢性肾衰竭中枢神经损害患者的独立危险因素。

objective To acquaintance the epidemiological investigation of nervous centralis damige of De Zhou City’s chronic renal failure patients(the CKD 5 period patients in maintenance hemodialysis) so as to develop the Clinical diagnosis and treatment level of this disease. Method To retrospective analysis the De Zhou City’s chronic renal failure patients with nervous centralis damige. Result The age, primary disease, serum creatinine, blood urea nitrogen, hemoglobin, carbon dioxide binding force, application of cephalosporin etc was statisticaly significant with the control group. Conclusion Diabetic nephropathy, high level of toxin, anemia, metabolic acidosis, using cephalosporins was independent risk factors of central nerve damage of chronic renal failure patients with in Dezhou city.

[目的]探讨在院内慢性肾衰竭常规治疗及护理的基础上,中药足浴法、中药灌肠法及中药足浴法结合中药灌肠法对慢性肾衰竭病人疗效的影响。[方法]将符合纳入标准的慢性肾衰竭病人按入院的先后顺序随机分成对照组、试验组1、试验组2、试验组3各30例,对照组给予院内常规治疗及护理,试验组1给予中药足浴法,试验组2给予中药灌肠法,试验组3给予中药足浴法结合中药灌肠法,比较4组病人的相关生化指标及临床有效率。[结果]对照组与各试验组间的相关生化指标及临床有效率的比较差异有统计学意义(P0.05)。[结论]在院内慢性肾衰竭常规治疗及护理的基础上,中药足浴法结合中药灌肠法能有效提高慢性肾衰竭临床疗效。

Objective:To probe into the effect observation on Chinese medicine foot bath,Chinese medicine enema method and combination of both methods for chronic renal failure patients on the basis of routine treatment and nursing of patients with chronic renal failure in hospital.Methods:The chronic renal failure inpatients who met the inclusion criteria were randomly divided into control group,group 1,group 2,group 3 based on the order,30 cases in each.On the basis of routine treatment and nursing,patients in group 1 were given Chinese medicine foot bath method,the patients in experimental group 2 were given Chinese medicine enema method,the patients in experimental group 3 received Chinese medicine foot bath method combined with traditional Chinese medicine enema method.The related biochemical indicators and clinical effectiveness were compared.Results:There was statistically significant difference in related biochemical indicators and clinical efficient between control group and all