严重烧伤后肾功能损害的临床研究

Clinical Study on Renal Damage in Severely Burned Patients

较全面地检测了５９例严重烧伤病人反映肾单位不同部位功能变化指标：肾小球滤过功能包括血尿素氮（ＢＵＮ），肌酐（Ｃｒ），肌酐清除率（Ｃｃｒ），血β２－微球蛋白（β２－ＭＧ），尿白蛋白（Ａｌｂ），近曲小管功能（尿β２－ＭＧ），髓襻、远曲小管及集合管功能（自由水清除率）等。结果表明：严重烧伤后肾单位不同部位均受损，动态观察其变化可了解烧伤后肾功能损害程度、转归及影响因素。本组肾功能衰竭以非少尿型为主，常合并其他内脏功能损害；结合功能与形态分析，肾小球和肾小管均受到严重损害。

The group of parameters used to evaluate renal functions were measured in 59 burn patients. The results demonstrated that damage to nephron unit was apparent and involved almost all of its segments, as evidenced by the following facts that the increase of BUN, Cr and blood β 2 MG,urine albumin,and the decrease of Ccr denoted the damage of the glomerular filtration; signifiuant increase of urine β 2 MG suggested the injury of the function of proximal tubule; the increased C H 2o indicated the injury of the function of Henle’s Loop, distal tubule and collecting duct. These parameters can be employeed to detect the early postburn renal disfunction. Among this group, non oliguric renal failure occured more often, there were 10 out of 12 renal failure cases, suggesting the glomerular and tubular damage can occure simultaneously after severely burn injury.