Suggested guidelines for treatment of acute renal failure in earthquake victims.
Suggested guidelines for treatment of acute renal failure in earthquake victims.
复制标题
地震灾民急性肾功能衰竭治疗建议指南。
DOI：
10.3109/08860229709109031
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发表时间：
1997
期刊：
影响因子：
3
通讯作者：
A. Rastegar
中科院分区：
文献类型：
--
作者：
I. Nadjafi;M. Atef;B. Broumand;A. Rastegar
1990年的伊朗地震影响了两个总人口为230万的州。它造成至少13,888人死亡，43,390人受伤，33,616人住院。住院患者总死亡率为0.17%。在全国156名需要透析支持的患者中诊断出急性肾衰竭（ARF），死亡率为14%。德黑兰医科大学三所教学医院共收治495例患者，总死亡率为7.5%。其中，30名患者（6%）需要透析，死亡率为40%，占死亡人数的12人。入院时，ARF患者损伤更严重，多发伤发生率显著增高；周围神经损伤；肌肉酶、钾、磷升高；尿检异常。在其中一家医院，患者接受了特殊的水合治疗方案，并采用了谨慎的筋膜切开术。ARF的发生率、与ARF相关的死亡率和筋膜切开术在该组均较低。基于这些发现，提出了可能有助于治疗地震受害者ARF的指南。
The 1990 Iran earthquake affected two states with a combined population of 2,300,000. It resulted in at least 13,888 deaths, 43,390 injured, and 33,616 hospitalized. The overall mortality among hospitalized patients was 0.17%. Acute renal failure (ARF) requiring dialysis support was diagnosed in 156 patients nationwide, with a mortality rate of 14%. Three teaching hospitals of Tehran University of Medical Sciences (UMS) admitted 495 patients, with total mortality of 7.5%. Of these, 30 patients (6%) required dialysis, with a mortality of 40%, accounting for 12 of the deaths. On admission, patients with ARF were more severely injured and had significantly higher incidence of multiple trauma; peripheral nerve injury; elevated muscle enzymes, potassium, and phosphorus; and abnormal urinalysis. In one of these hospitals, patients were treated with a specific hydration protocol coupled with a cautious approach to fasciotomy. The incidence of ARF, mortality associated with ARF, and fasciotomy were lower in this group. Based on these findings, guidelines are suggested that may be helpful in the treatment of ARF in earthquake victims.