挤压综合征相关急性肾损伤的诊疗进展

Advances in Diagnosis and Management of Acute Kidney Injury Induced by Crush Syndrome

挤压综合征广泛存在于自然灾害、创伤及交通事故中,主要表现为低血容量休克、急性肾损伤、高钾血症、酸中毒等,其中急性肾损伤是挤压综合征患者病死率居高不下的重要因素之一。目前挤压综合征相关急性肾损伤的治疗包括早期补液、对症治疗及肾脏替代疗法等,然而效果并不理想。国内外针对挤压综合征相关急性肾损伤的治疗尚无标准方案,因此明确发病机制及制定有效治疗方案可能是未来亟待解决的问题。本文就挤压综合征相关急性肾损伤的发病机制及治疗策略进行综述。

Crush syndrome(CS)often occurs in victims of natural disasters,trauma and traffic accidents,which mainly manifests as hypovolemic shock,acute kidney injury(AKI),hyperkalemia,and acidosis,among which AKI is a major cause of the continuing high mortality of CS.Current treatments for AKI induced by CS include early rehydration,symptomatic treatment and renal replacement therapy,but the effects are not satisfactory.There are no standard treatment options for CS-related AKI,so identifying the pathogenesis of this disease and formulating an effective treatment regimen may be problems need to be solved urgently.This article reviews the latest advances in pathogenesis and treatment strategies of CS-related AKI.