镜像综合征合并急性肾损伤的诊治并文献复习

Diagnosis and treatment of mirror syndrome associated with acute kidney injury

目的探讨镜像综合征合并急性肾损伤的机制、治疗及预后。方法回顾性分析清远市人民医院2008-01~2016-06收治的4例镜像综合征合并急性肾损伤病例,复习有关文献,探讨镜像综合征合并急性肾损伤的机制、治疗及预后。结果 4例镜像综合征合并急性肾损伤患者终止妊娠前尿量均<0.5 ml/(kg·h),持续时间6~9 h,2例出现高血压;3例入院后经阴道自然分娩,1例剖宫取胎;4例患者均使用呋塞米利尿,使用总剂量60~80 mg;4例患者终止妊娠后病情迅速缓解,临床治愈时间14~16 d。结论 (1)早期诊断和及时终止妊娠对于改善镜像综合征合并急性肾损伤的预后至关重要。(2)袢利尿剂的使用时机和剂量尚需进一步研究。

Objective To discuss the mechanism,treatment and prognosis of mirror syndrome associated with acute kidney injury. Methods 4 patients with mirror syndrome associated with acute kidney injury were collected from the People＇s Hospital of Qingyuan City during January 2008 and June 2016 and their clinical data were retrospectively analyzed. Results All of the 4 cases had oliguria[ 〈0. 5 ml/（ kg·h） ],among whom 2 had high blood pressure. Three patients terminated through vagina,and the rest was terminated by cesarean. All of the 4 patients were treated with furosemide,and the total dose was up to 60 - 80 mg. All of the four patients recovered immediately after the termination,and the recovery time was between 14 and 16 days. Conclusion（ 1） The key points to improve the prognosis of mirror syndrome with acute kidney injury are early diagnosis and timely termination of pregnancy.（ 2）The timing and dose of loop diuretics need further study.