{"nowTime30":1785137394092,"lyBarModerator":null,"metaSearch":{"description":"尿毒症透析效果与高血压的相关性方面非常密切，对肾脏病晚期尿毒症患者而言，高血压患病率具有高、顽固、不易控制三个特点。 \n首先我们谈谈正常的血压特点。正常血压在120/80mmHg左右，脉压30～40mmHg。血压波动有昼夜节律，夜间血压最低，晨起活动后迅速上升，在上午6～10点和下午4～8点各有一高","keywords":"尿毒症透析效果与高血压的相关性_洞医","title":"尿毒症透析效果与高血压的相关性_洞医","channels":null},"identificate":{"id":"0300b4bddfaf11e6a61c00163e04584d","isDel":0,"createAt":1484985344390,"createBy":"b1a5ca4ddfad11e6a61c00163e04584d","createName":"小海螺","updateAt":0,"updateBy":null,"updateName":null,"userId":"b1a5ca4ddfad11e6a61c00163e04584d","realName":"赵玉","certifiedStatus":2,"phone":"111111111111","email":"2276635444@qq.com","hospitalId":"31c19c1b453011e69d4700163e005165","departmentId":"2000","illName":"","illId":"793a72a2bb5f11e6a61c00163e04584d","cardType":1,"cardImg":"http://01luntan.com/ly_img/1484985951761.jpg","idCardImg":"","identityType":2,"stop":0,"departmentName":"儿科","hospitalName":null},"canEdit":null,"adList":[],"lyBar":{"id":"1696","isDel":0,"createAt":1483439342218,"createBy":"system","createName":"system","updateAt":0,"updateBy":null,"updateName":null,"userId":null,"name":"北京协和医院肾内科","type":101,"twoCode":"http://zhao01.com/zly_img/zly_wx.jpg","image":null,"provinceId":"110000","cityId":"110101","illId":null,"hospitalId":"15009","keyWord":null,"totleTopic":0,"barDesc":null,"discussBarType":null,"metaSearch":"{\"description\":\"洞医为您提供:北京协和医院肾内科电话、北京协和肾内科专家、协和医院肾脏内科病友的治疗经验等相关信息，让您在便捷的求医路上不花一分冤枉钱。\",\"keywords\":\"北京协和医院肾内科电话_北京协和肾内科专家_协和医院肾脏内科_洞医\",\"title\":\"北京协和医院肾内科电话_北京协和肾内科专家_协和医院肾脏内科_洞医\"}","adInfo":null},"isLikeThisTopic":null,"lastTopics":[{"id":"3517","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"急性肾盂肾炎 如何预防急性肾盂肾炎","content":"<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal; text-align: left;\">　　肾病对于患者来说是个严重的打击，因为它给患者带来的伤害非常大，所以大家要做好预防工作。急性肾盂肾炎是一种很常见的感染性疾病，在我们生活中有很多人会因为大肠杆菌的感染而患上急性肾盂肾炎。那患上急性肾盂肾炎有什么症状呢?急性肾盂肾炎又应该如何进行治疗呢?今天小编就来为大家一一介绍一下，想知道的朋友就来看一下吧。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　<strong style=\"color: #333333;\">　急性肾盂肾炎症状</strong></p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　对于我们来说，知道急性肾盂肾炎的症状是非常有必要的。因为如果知道急性肾盂肾炎症状的话，我们就可以早发现，早治疗了，不是吗?那急性肾盂肾炎有什么症状表现呢?</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　1.一般症状</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　高热，寒战，体温多在38～39℃，也可高达40℃，热型不一，一般呈弛张型，也可呈间歇或稽留型，伴头痛，全身酸痛，热退时可有大汗等。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　2.泌尿系症状</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　患者有腰痛，多为钝痛或酸痛，程度不一，少数有腹部绞痛，沿输尿管向膀胱方向放射;体检时在上输尿管点(腹直肌外缘与脐平线交叉点)或肋腰点(腰大肌外缘与十二肋交叉点)有压痛，肾区叩痛阳性，患者常有尿频，尿急，尿痛等膀胱刺激症状，在上行性感染时，可先于全身症状出现。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　3.胃肠道症状</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　急性肾盂肾炎患者会出现恶心，呕吐，食欲不振的症状，而有些患者则会出现腹部疼痛的情况。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　4.菌血症和脓毒血症</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　有症状的急性肾盂肾炎患者，在其疾病过程中都可并发菌血症。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　5.休克和弥散性血管内凝血(DIC)</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　6.儿童患者</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　儿童患者的泌尿系症状常不明显，起病时除高热等全身症状外，常有惊厥，抽搐发作，2岁以下小儿可出现发热，呕吐，非特异性的腹部不适或不好动。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　<strong style=\"color: #333333;\">　急性肾盂肾炎治疗</strong></p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　患上急性肾盂肾炎应该如何进行治疗呢?治疗急性肾盂肾炎的方法又有哪些呢?相信这个每一位急性肾盂肾炎患者都想要知道的答案，那下面我们就一起来看一下急性肾盂肾炎的治疗方法吧。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　1.全身支持治疗</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　卧床休息，给予足够营养，补充液体、多饮水，维持每日尿量达1.5L以上。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　2.抗菌药物治疗</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　急性肾盂肾炎病情较急，需要及时处理，在细菌培养尚未明确前，根据尿涂片染色结果选用毒性小的广谱抗生素治疗。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　(1)SMz&mdash;TMP对革兰阳性及阴性菌有效。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　(2)喹诺酮类药物抗菌谱广、作用强，临床广泛应用，但不宜用于儿童和孕妇。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　(3)革兰阴性杆菌可选用头孢菌素、广谱青霉素、氨基糖苷类抗生素或复方磺胺甲恶唑。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　(4)去甲万古霉素适用于革兰阳性球菌感染，亚胺培南-西拉司丁钠对革兰阴性杆菌活性好，二者尤适用于难治性院内感染和免疫缺陷者的肾盂肾炎。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　(5)首次发生肾盂肾炎的致病菌多为大肠杆菌及粪链球菌引起。临床上应根据病人症状和疾病的严重程度选择治疗。在尿细菌定量培养及药敏试验结果来获得之前，可凭医生的经验选择使用抗生素，一般选择对革兰阴性杆菌有效的抗生素并兼治革兰阳性菌感染。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　(6)轻型肾盂肾炎治疗，口服抗生素2周是传统疗程。常用药物为复方磺胺甲恶唑lg，每天2次;氧氟沙星0.2g，每天2次;阿莫西林0.5g，每天4次。通过上述治疗通常尿菌的阴转率达90%左右，如果尿菌仍呈阳性时，应根据药敏结果选择有效的抗生素，疗程为4～6周。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　(7)病情危重者，根据药敏结果选择用强有力抗生素，选择的药物有氨苄西林1～2g，每天4次;或头孢噻肟钠2g，每天2次。必要时联合用药，疗程为2周。一般均选用静脉滴注途径用药。有复杂因素的肾盂肾炎病人，往往致病菌产生耐药性，治疗困难，应按药敏试用奈替米星2mg/kg;每12小时一次;头孢氨噻三嗪2.0g，每天1次;氨曲南2.0，每天3次;对耐青霉素者，可选用美洛西林舒巴坦类药物。氨基苷类抗生素肾毒性大，应慎用，对原有慢性肾脏病者或老年人应尽量避免使用。复杂性肾盂肾炎易发生革兰阴性杆菌败血症，应联合使用两种或两种以上抗生素静脉治疗。用药期间应定期复查尿菌培养以观察治疗效果。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　(8)根据尿液细菌培养结果和对抗生素敏感情况，选用有效抗生素，尤其在治疗过程中出现细菌耐药时，应根据细菌培养及药物敏感试验结果，重新调整抗菌药物。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　(9)选用抗生素时，应考虑药物的肾毒性，伴有肾功能不良者，应使用对肾脏毒性小的药物。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　(10)抗菌药物的治疗宜个体化。静脉用药者可在体温正常、临床症状改善、尿培养阴性后改用口服维持。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　3.中药治疗</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　以小柴胡汤为主。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　<strong style=\"color: #333333;\">急性肾盂肾炎的预防方法</strong></p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　1、坚持每天多饮水，以增加排尿的次数，从而达到冲洗膀胱和尿道的作用。避免细菌在尿路繁殖，这是既简便又有效的方法。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　2、注意阴部清洁，以减少尿道口的细菌群，必要时可用新霉素或呋喃旦啶油膏涂于尿道口旁黏膜或会阴部皮肤，以减少上行性再发感染。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　3、尽量避免使用尿路器械，必要时应严格无菌操作。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　4、反复发作的肾盂肾炎妇女，应每晚服一个剂量的抗菌药预防，可任选复方新诺明、呋喃旦啶、阿莫西林或头孢拉啶等药物中一种，如无不良反应，可用至1年以上。如发病与房事有关，于性生活后宜立即排尿，并服一个剂量的抗生素，也可减少肾盂肾炎的再发。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　日常养护</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　1、重视女性保健工作，妇女要保持外阴清洁，慎用盆浴。月经期、妊娠期及婴儿要特别注意讲卫生，防止上行感染。患有急性肾盂肾炎妇女，治疗后一年内应避孕，以免怀孕而加重病情。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　2、急性肾盂肾炎或慢性肾盂肾炎急性发作期都应多饮水，每日摄入量2500毫升以上。目的增加尿量，促进细菌、毒素及炎症分泌物排出。同时要注意加强营养和身体锻炼。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　3、注意观察有无发烧和尿路刺激症状。慢性肾盂肾炎后期，注意有无肾脏损害症状，如高血压、贫血、尿毒症等。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　4、药物治疗后，注意有无药物的副反应，如口服药物后引起恶心、呕吐、食欲减退等反应询问医生后，方可改用其他药物治疗。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　<strong style=\"color: #333333;\">其他事项</strong></p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　1、如果急性肾盂肾炎诊断、治疗及时，则很少出现并发症。并发于有潜在肾脏病或尿路畸形的急性肾盂肾炎的预后相对较差，而且致病菌常有耐药性，如不去除肾结石，尤其是合并感染的结石，否则肾盂肾炎难以控制。并发于尿路梗阻的感染也很难治愈，常演变为慢性过程，并可导致菌血症。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　2、急性肾盂肾炎最严重的并发症是中毒性休克。产气型肾盂肾炎是一种很少见但可致命的肾盂肾炎，通常见于糖尿病患者，由致病菌常是大肠杆菌的某一菌株释放气体进入感染组织所致。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　3、在得到充分治疗后，又无其他肾脏疾病或尿路畸形，急性肾盂肾炎通常可痊愈，并不引起肾脏瘢痕或持续性肾脏损害，相反在肾脏未完全发育成熟的婴幼儿，尤其是并发于肾脏疾病或尿路畸形的急性肾盂肾炎，常引起持续肾脏损害和瘢痕。</p>\n<p>&nbsp;</p>","barId":"1696","topicTypeId":null,"topicThemeId":"1023","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":1},{"id":"5555","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"看协和医院专家为您解读透析病人的饮食注意事项","content":"<p style=\"line-height: 200%;\">&nbsp; &nbsp;<span style=\"font-size: 19px; line-height: 200%; font-family: 宋体; color: #333333;\">慢性肾功能衰竭。上述问题的主要原因是摄入的热卡大于需要。所以目前许多学者现在都认为：大部分的高血压、糖尿病是可以预防的，其中关键是合理的饮食。那么<strong><span style=\"font-size: 19px; line-height: 38px; font-family: 宋体; color: #333333;\">透析病人的饮食注意事项都有哪些呢？</span></strong><span style=\"font-size: 19px; line-height: 38px; color: #333333;\">&nbsp;</span></span><span style=\"font-size: 19px; line-height: 200%; color: #333333;\"><br /> &nbsp;&nbsp;<span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">透析病人的饮食的&ldquo;食&rdquo;包括两个方面的问题，吃多少和吃什么？</span></span><span style=\"font-size: 19px; line-height: 200%; color: #333333;\"><br /> &nbsp;&nbsp;<span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">摄入大于需求，会导致高脂血症、动脉硬化及心脑血管病变；摄入小于需求，会导致营养不良、炎症和动脉硬化。营养不良是血透病人和腹透病人死亡的重要不良预后指标。透析病人吃多少，这个问题已经有了答案。</span></span><span style=\"font-size: 19px; line-height: 200%; color: #333333;\"><br /> &nbsp;&nbsp;&nbsp; <span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">腹膜透析病人每周经腹透液吸收</span><span style=\"font-size: 19px; line-height: 200%;\"> 500-2100 g</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">糖，同时丢失</span><span style=\"font-size: 19px; line-height: 200%;\">80-100 g </span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">氨基酸、</span> <span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">蛋白质，发生腹膜炎时，氨基酸和蛋白质的丢失量增加</span><span style=\"font-size: 19px; line-height: 200%;\">1</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">倍。因此腹膜透析病人的营养特点为蛋白质营养不足，热卡摄入过多，高脂血症多见。目前推荐腹膜透析病人蛋白质摄入量为</span><span style=\"font-size: 19px; line-height: 200%;\">1.3 g/kg /</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">天，其中至少</span><span style=\"font-size: 19px; line-height: 200%;\">50% </span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">为优质蛋白；热卡摄入量：</span><span style=\"font-size: 19px; line-height: 200%;\">25kcal/kg/</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">天。</span></span><span style=\"font-size: 19px; line-height: 200%; color: #333333;\"><br /> &nbsp;&nbsp;&nbsp; <span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">血透病人每周经透析液丢失</span><span style=\"font-size: 19px; line-height: 200%;\">36-75 g</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">糖，丢失</span><span style=\"font-size: 19px; line-height: 200%;\">33-45 g</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">氨基酸、蛋白质，因此容易出现蛋白质</span><span style=\"font-size: 19px; line-height: 200%;\">-</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">能量摄入均不足。目前推荐血透病人蛋白质摄入量：</span><span style=\"font-size: 19px; line-height: 200%;\">1.2 g/kg /</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">天，其中至少</span><span style=\"font-size: 19px; line-height: 200%;\">50% </span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">为优质蛋白；热卡摄入量：</span><span style=\"font-size: 19px; line-height: 200%;\">35 kcal/kg/</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">天</span> <span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">（年龄</span><span style=\"font-size: 19px; line-height: 200%;\">&lt;60</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">岁）或</span><span style=\"font-size: 19px; line-height: 200%;\">30 kcal/kg /</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">天（年龄</span><span style=\"font-size: 19px; line-height: 200%;\">&gt;60</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">岁）。</span><span style=\"font-size: 19px; line-height: 200%;\">&nbsp;&nbsp;&nbsp;&nbsp;</span><br /> &nbsp;&nbsp;&nbsp; <span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">、在物质生活极度发达的今天，什么能吃，什么不能吃或少吃，都是非常讲究的。在全球，日本血透病人的存活率最高；在美国，亚裔血透病人的死亡率最低。日本人的饮食习惯与欧美不同，如鱼、大豆蛋白摄入较多，食物成分低脂、多膳食纤维，具有抗炎症和抗氧化作用。这些都值得借鉴。</span></span></p>\n<p style=\"line-height: 200%; text-align: center;\"><span style=\"font-size: 19px; line-height: 200%; color: #333333;\"><strong><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\"><img title=\"透析病人的饮食注意事项\" src=\"http://01luntan.com/ly_img/uimgs/1503061193133.jpg\" alt=\"透析病人的饮食注意事项\" width=\"600\" height=\"450\" /></span></strong></span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%; color: #333333;\"><strong><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">&nbsp; &nbsp; 鱼</span></strong></span><span style=\"font-size: 19px; line-height: 200%; color: #333333;\"><br /> &nbsp;&nbsp;&nbsp; <span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">鱼油中含有较多的&omega;</span><span style=\"font-size: 19px; line-height: 200%;\">-3</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">脂肪酸，具有抗炎症作用和心血管保护作用。有研究发现，鱼油可以降低非肾脏病人的</span><span style=\"font-size: 19px; line-height: 200%;\">CRP </span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">和</span><span style=\"font-size: 19px; line-height: 200%;\">IL-6 </span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">。研究还发现，长期食用鱼类的透析病人死亡率降低</span><span style=\"font-size: 19px; line-height: 200%;\">50 </span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">％。</span></span></p>\n<p style=\"line-height: 200%; text-align: center;\"><img title=\"透析病人的饮食注意事项\" src=\"http://01luntan.com/ly_img/uimgs/1503061063177.jpg\" alt=\"透析病人的饮食注意事项\" width=\"600\" height=\"450\" /></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%; color: #333333;\"> &nbsp;&nbsp;&nbsp; <strong><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">豆腐</span></strong></span><span style=\"font-size: 19px; line-height: 200%; color: #333333;\"><br /> &nbsp;&nbsp; <span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">大豆中含有丰富的植物雌激素，包括染料木黄酮和异黄酮苷。植物雌激素除了对激素依赖性肿瘤具有保护作用以外，还可以调节细胞的生长、增生，并通过阻断炎症基因的表达抑制炎症反应和氧化应激反应。</span></span></p>\n<p style=\"line-height: 200%; text-align: center;\"><span style=\"font-size: 19px; line-height: 200%; color: #333333;\"><img title=\"透析病人的饮食注意事项\" src=\"http://01luntan.com/ly_img/uimgs/1503061465402.jpg\" alt=\"透析病人的饮食注意事项\" width=\"600\" height=\"450\" />&nbsp; &nbsp;&nbsp;</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%; color: #333333;\"><strong><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">&nbsp; &nbsp; 富含膳食纤维的食物</span></strong></span><span style=\"font-size: 19px; line-height: 200%; color: #333333;\"><br /> &nbsp;&nbsp;&nbsp;<span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">摄入膳食纤维多的病人血中的</span><span style=\"font-size: 19px; line-height: 200%;\">CRP</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">水平较低，具有较强的抗炎和抗氧化作用。许多食物富含膳食纤维，如土豆、红薯、麦片等。</span>此外，适量摄入水果、蔬菜、木耳、坚果类和瓜子，适量饮酒（每天一杯干红或啤酒），也具有抗氧化和抗炎作用，对心血管具有保护作用。</span><span style=\"font-size: 19px; line-height: 200%; color: #333333;\"><br /> &nbsp;&nbsp;&nbsp;&nbsp; <strong><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">透析病人的饮食禁忌</span></strong></span><span style=\"font-size: 19px; line-height: 200%; color: #333333;\"><br /> &nbsp;&nbsp;&nbsp; &nbsp;<span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">透析病人最好不要食用煎、炒、烹、炸的食物、高胆固醇的食物（如蛋黄、鱼籽、虾头）。盐的摄入量一定要控制在</span><span style=\"font-size: 19px; line-height: 200%;\">6</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">克以内，不能食用咸菜、炸酱、豆腐乳等，炒菜时少放盐或不放盐。</span></span><span style=\"font-size: 19px; line-height: 200%; color: #333333;\"><br /> </span><strong><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体; color: #333333;\">透析病人的饮食推荐案例</span></strong><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体; color: #333333;\">：</span><span style=\"font-size: 19px; line-height: 200%; color: #333333;\"> 60</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体; color: #333333;\">公斤的透析病人食谱（蛋白质摄入量为</span><span style=\"font-size: 19px; line-height: 200%; color: #333333;\">72-78</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体; color: #333333;\">克，热卡</span><span style=\"font-size: 19px; line-height: 200%; color: #333333;\">1800kcal/d</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体; color: #333333;\">）</span><span style=\"font-size: 19px; line-height: 200%; color: #333333;\">:</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体; color: #333333;\">牛奶</span><span style=\"font-size: 19px; line-height: 200%; color: #333333;\">500 ml</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体; color: #333333;\">，鸡蛋</span><span style=\"font-size: 19px; line-height: 200%; color: #333333;\">2</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体; color: #333333;\">个（去黄），肉</span><span style=\"font-size: 19px; line-height: 200%; color: #333333;\">3-4</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体; color: #333333;\">两（鱼、瘦肉猪肉），豆腐</span><span style=\"font-size: 19px; line-height: 200%; color: #333333;\">1-2</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体; color: #333333;\">两，谷类</span><span style=\"font-size: 19px; line-height: 200%; color: #333333;\">3-5</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体; color: #333333;\">两（适当补充富含膳食纤维的杂粮），蔬菜、水果</span><span style=\"font-size: 19px; line-height: 200%; color: #333333;\">500</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体; color: #333333;\">克。</span></p>\n<p>&nbsp;</p>","barId":"1696","topicTypeId":null,"topicThemeId":"1022","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":6},{"id":"2198","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"狼疮肾炎并发高血尿酸症","content":"<p><span style=\"color: #333333; font-family: 'Hiragino Sans GB', Helvetica, 'microsoft yahei', simsun, arial; font-size: 14px; line-height: 32px; background-color: #fcfcfc;\">女,36岁。06年在解放军301医院确诊为系统性红斑狼疮，肾活检狼疮性肾炎IV，08年和11年复发两次住院。06-08年强的松和骁悉维持治疗，后因反复感染带状疱疹停用骁悉改为ctx静滴，用药两年后，改为每日强的松+纷乐维持至今。11年后由于国外工作当地的医生交流有限和看病的繁琐复杂一直没有复查，只是每年回国化验一次重要指标，14年发现尿酸偏高，肌酐升高肾功能开始下降，医生开了苯溴马龙和碳酸氢钠用药两年无缓解，期间痛风反复发作，关节疼痛以为是狼疮活动，没有规范治疗和重视高尿酸症状，去年开始大量小颗粒的痛风石出现在手上，关节有点变形，时常疼痛，而且手已经不能弯曲自由活动，有时疼痛起来浑身没有力气发烧昏迷，不能行走也无法工作，严重影响了我的生活。想起这些年一直在吃降压药和利尿剂，没有复查及时调整用药，是痛风石形成的主要原因，悔之莫及！年前检查尿酸560，肌酐150，无蛋白尿补体正常，请问刘教授如何在不诱发狼疮活动、肾功能不会进一步恶化的前提下更好的降尿酸溶解痛风石？肾功能恶化是否和高尿酸有关系？我这种情况痛风石比较多会不会已经沉积在肾脏？</span></p>","barId":"1696","topicTypeId":null,"topicThemeId":"1020","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":2},{"id":"4092","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"多囊肾尿毒症的治疗建议","content":"<p><span style=\"color: rgb(51, 51, 51); font-family: &#39;Hiragino Sans GB&#39;, Helvetica, &#39;microsoft yahei&#39;, simsun, arial; font-size: 14px; line-height: 32px; background-color: rgb(252, 252, 252);\">2015年8月份受惊吓血压升高昏迷，后身体逐渐虚弱，2016年4月份诊断为肾结石及甲亢，后甲亢治愈。9月份诊断为多囊肾，肌酐600多，血压偶有身高，最高纪录为160。现在肌酐升至786，尿酸551。左足肿痛，后吃秋水仙碱及小苏打渐渐好转</span></p><p><span style=\"color: rgb(51, 51, 51); font-family: &#39;Hiragino Sans GB&#39;, Helvetica, &#39;microsoft yahei&#39;, simsun, arial; font-size: 14px; line-height: 32px; background-color: rgb(252, 252, 252);\">病人对透析有抗拒心理，想通过中药治疗。请问是否应该做透析？有无其他治疗办法？透析后有无好转后不再透析的可能？谢谢！</span><br/></p>","barId":"1696","topicTypeId":null,"topicThemeId":"1019","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":1},{"id":"4450","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"患上肾衰后患者都会出现哪些症状","content":"<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　可想而知，如果我们的肾脏出现了问题那后果将是非常严重的，肾衰是肾功能下降的一种表现，肾脏功能几乎快丧失时，这种疾病的症状才会很明显。初期如身体不适，恶心，尿频等症状，这些大多数人都不会和肾衰画上等号。那么如果在肾衰初期不及时控制并治疗的话，很可能会发展为尿毒症，最终成为身体的负担。</p><p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　患上肾衰患者会出现以下症状：</p><p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　1、身体不适，由于毒素和废物在体内不断堆积，肾衰病人可能会感到浑身不适。症状包括恶心，呕吐，夜间睡眠不好，没有胃口，搔痒和疲劳。一些肾衰病人会出现水肿现象。尿量减少，尿频(尤其在夜间)。手足踝水肿。其它症状还有气短，眼睛周围肿胀。由于肾脏功能遭受损害，人体不能产生制造红细胞所需的足够荷尔蒙，因而产生贫血。贫血的人经常会感到寒冷和疲惫。甚至还会出现其他症状，如血尿(呈茶色或血红色)、高血压、尿液中出现泡沫、腹泻、极度口渴、睡眠不安，或嗜睡、性欲下降。</p><p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　2、急性肾衰急性肾衰的病情进展快速，通常是因肾脏血流供应不足(如外伤或烧伤)、肾脏因某种因素阻塞造成功能受损或是受到毒物的伤害，引起急性肾衰竭的产生。慢性肾衰是指各种肾脏疾病引起的缓慢进行性肾功能损害最后导致尿毒症和肾功能完全丧失，引起一系列临床症状和生化内分泌等代谢紊乱组成的临床综合征，从原发病起病到肾功能不全的开始，间隔时间可为数年到十余年。</p><p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　3、尿渗透压降低比重低，多在1.018以下，严重时固定在1.010～1.012之间，作尿浓缩稀释试验时夜尿量大于日尿量，各次尿比重均超过1.020，最高和最低的尿比重差小于0.008。尿量减少多在每日1000毫升以下。尿蛋白定量增加晚期因肾小球绝大部分已损伤，尿蛋白反而减少。尿沉渣检查肾衰患者时可有多少不等的红细胞、白细胞、上皮细胞和颗粒管型，蜡样管型最有意义。肾功能检查肾衰患者各项指标均提示肾功能减退。血生化检查血浆中白蛋白减少，血钙偏低，血磷增高，血钾和血钠随病情而定。</p><p><br/></p>","barId":"1696","topicTypeId":null,"topicThemeId":"1016","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":1},{"id":"3370","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"肾衰竭患者有哪些危险症状","content":"<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　生活中很多人都知道，肾衰竭是一种比较严重的肾病，它会导致很多并发症的发生，而且在治疗上的难度也很大，那么到底肾衰竭会让患者出现哪些危险症状呢？下面我们就给大家介绍七种比较常见的症状，希望患者朋友能做好这些疾病的预防。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　一、肾衰竭会造成消化系统疾病</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　对于肾衰竭，一般会给患者造成口渴，厌食，恶心，呕吐，等症状，这就是严重的消化系统疾病的症状，重度肾衰竭患者出现鼻出血或消化道出血。所以对于患者来讲应该加强肾衰竭的护理工作。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　二、肾衰竭会造成心血管系统疾病</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　对于肾衰竭患者来讲，随着病情进展，血压都会不同程度的升高，最后发展成高血压。而长期高血压，会使患者体内的尿毒素的蓄积、水、电解质等发生紊乱，给患者带来严重的伤害。给患者造成了心血管系统的一些疾病，所以对于肾衰竭患者应该多加的注意。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　三、肾衰竭会造成造血系统疾病</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　肾衰竭患者多半都会贫血，这种主要是由于患者体内的肾脏造血功能的减弱，促红细胞生成素减少，从而出现了贫血。而这种贫血会造成患者体内尿毒症毒素的蓄积以及红细胞寿命的羧酸以及营养不良等因素有关。给患者带来严重的伤害。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　四、肾衰竭会造成神经系统疾病</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　对于早期的肾衰竭患者一般都会出现头痛、记忆力减退、注意力不集中、乏力等症状。晚期患者会出现嗜睡、神志模糊、肌肉颤动等症状。这些都是由于神经系统病变使所引发的，所以对于肾衰竭患者应该在神经方面多加的注意。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　五、肾衰竭会造成呼吸系统疾病</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　肾衰竭多伴有干咳，鼻腔异味的症状，这是影响到伴有肺水肿或心功能减退性衰竭时，呼吸更加困难，不能平卧，阵发性、痉挛性咳嗽，咳白色泡沫。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　六、肾衰竭会造成泌尿系统疾病</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　肾衰竭早、中期，出现大量泡沫样尿液，晚期夜尿增多，尿比重低，经常固定在1.010左右。此时，不但肾脏体积缩小，而且多数病人尿量开始由多逐渐减少以至于无尿。当然，尿量从增多到减少到无尿，需要一个过程，1-2年不等。</p>\n<p>&nbsp;</p>","barId":"1696","topicTypeId":null,"topicThemeId":"1015","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":1}],"pageObj":{"list":[],"list4Map":null,"pageBegin":0,"pageSize":5,"pageNumber":0,"totalPage":0,"totalRow":0},"loginUser":null,"replies":[],"forumUserFans":null,"herfList":[],"only":"0","topic":{"id":"5554","isDel":0,"createAt":1503059887841,"createBy":"b1a5ca4ddfad11e6a61c00163e04584d","createName":"小海螺","updateAt":0,"updateBy":null,"updateName":null,"userId":"b1a5ca4ddfad11e6a61c00163e04584d","title":"尿毒症透析效果与高血压的相关性","content":"<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">&nbsp; </span><strong><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">尿毒症透析</span></strong><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">效果与高血压的相关性方面非常密切，对肾脏病晚期尿毒症患者而言，高血压患病率具有高、顽固、不易控制三个特点。</span><span style=\"font-size: 19px; line-height: 200%;\">&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">&nbsp;&nbsp;</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">首先我们谈谈正常的血压特点。正常血压在</span><span style=\"font-size: 19px; line-height: 200%;\">120/80mmHg</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">左右，脉压</span><span style=\"font-size: 19px; line-height: 200%;\">30</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">～</span><span style=\"font-size: 19px; line-height: 200%;\">40mmHg</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">。血压波动有昼夜节律，夜间血压最低，晨起活动后迅速上升，在上午</span><span style=\"font-size: 19px; line-height: 200%;\">6</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">～</span><span style=\"font-size: 19px; line-height: 200%;\">10</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">点和下午</span><span style=\"font-size: 19px; line-height: 200%;\">4</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">～</span><span style=\"font-size: 19px; line-height: 200%;\">8</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">点各有一高峰。影响血压波动的因素较多，如活动、饱食、情绪激动、精神紧张、寒冷、失眠、吸烟、饮酒和饮咖啡等都会影响血压的变化。高血压患者应当学会自己在家中监测血压，可以随时取得数值，这种检测结果更接近日常生活状态，结果更可靠。测血压的要求：</span><span style=\"font-size: 19px; line-height: 200%;\">1</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">、安静休息</span><span style=\"font-size: 19px; line-height: 200%;\">5</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">∽</span><span style=\"font-size: 19px; line-height: 200%;\">10</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">分钟，坐</span><span style=\"font-size: 19px; line-height: 200%;\">/</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">卧位；</span><span style=\"font-size: 19px; line-height: 200%;\">2</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">、袖带须松紧合适，下缘距肘上</span><span style=\"font-size: 19px; line-height: 200%;\">1-2</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">厘米，与心脏水平；</span><span style=\"font-size: 19px; line-height: 200%;\">3</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">、放气速度缓慢均匀，声音刚出现时为收缩压（</span><span style=\"font-size: 19px; line-height: 200%;\">SBP</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">）声音消失时为舒张压（</span><span style=\"font-size: 19px; line-height: 200%;\">DBP</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">）</span></p>\n<p style=\"line-height: 200%; text-align: center;\"><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\"><img title=\"尿毒症透析效果与高血压的相关性\" src=\"http://01luntan.com/ly_img/uimgs/1503060448502.jpeg\" alt=\"尿毒症透析效果与高血压的相关性\" width=\"600\" height=\"450\" /></span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">&nbsp;&nbsp;</span><strong><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">尿毒症透析患者</span></strong><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">控制血压的意义是什么呢？高血压一般没有症状，但长期高血压可以造成心脏、脑血管、肾脏等内脏器官的损害，一旦出现难以逆转，所以医学界把高血压称为&ldquo;沉默杀手&rdquo;。高血压的危害非常多：增加脑出血风险，可造成中风</span><span style=\"font-size: 19px; line-height: 200%;\">, </span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">痴呆；心脏损害突出，导致高血压性心脏病、心肌梗塞，心力衰竭等；与肾脏损害互为因果，高血压本身可导致肾功能不全；还可加速全身动脉粥样硬化的产生。研究结果表明：心血管的死亡率与血压水平成正比。合理降压可以减少严重并发症的发生；收缩压每降低</span><span style=\"font-size: 19px; line-height: 200%;\">10</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">毫米汞柱，可减低</span><span style=\"font-size: 19px; line-height: 200%;\">56</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">％的中风和</span><span style=\"font-size: 19px; line-height: 200%;\">37</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">％的冠心病发生。</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">&nbsp; &nbsp;</span><strong><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">尿毒症透析</span></strong><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">患者血压控制在多少呢？目标血压应个体化，为其可耐受的最低血压，多要求控制在</span><span style=\"font-size: 19px; line-height: 200%;\">130-140/80-90mmHg</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">左右。对于<strong>尿毒症透析</strong>的患者，高血压的治疗是一种综合治疗，需要终生治疗，其内容包括生活方式的改变与危险因素的控制、血液净化治疗、药物治疗、手术治疗等。<strong>尿毒症透析</strong>患者的生活方式改变也非常重要，是成功控制血压的基础和前提，重要程度已经远远超过药物治疗。因此应当重视生活保健。</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">&nbsp;&nbsp;&nbsp;</span><strong><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">尿毒症透析</span></strong><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">患者平时要保持乐观向上的生活态度和稳定的情绪；保持生活起居规律，睡眠充足；肥胖患者要注意控制体重；戒除烟酒等不良嗜好；坚持适量运动，按照循序渐进、持之以恒，量力而行的原则，可以参加慢跑、打太极拳等活动；另外，排便宜选坐位，要多吃粗粮及蔬菜，以防便秘。饮食以清淡为主，避免进食肥腻、刺激性、高胆固醇及腌制的食物，烹调方法应以蒸、滚、氽为主，避免煎炸，少肉多菜，肉类以瘦肉为主，去膏去皮，少盐、少糖、少油，多吃含维生素和纤维素丰富的蔬菜和水果。提高睡眠质量对血压控制也很有意义。可以中午小睡，使全身放松；晚餐宜少，清淡为主；睡前娱乐活动要有节制，不可计较输赢或过于认真激动，不宜长时间看电视；起床宜缓特别对于长期服用降压药的患者，应当缓缓起身，防止过急而晕倒。</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">&nbsp;&nbsp;</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">对于少尿或无尿的透析患者，调整透析处方，合理控制体重对控制血压非常有帮助。这类患者的高血压多为容量依赖性，通过降低体重，可以控制</span><span style=\"font-size: 19px; line-height: 200%;\">50-80%</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">的高血压。排除体内过多的水负荷，也是药物治疗的前提。但主要困难是：</span><span style=\"font-size: 19px; line-height: 200%;\">1</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">、透析间期体重上升过多，进水过多达不到干体重，透析时患者难以耐受大剂量的超滤</span> <span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">；</span><span style=\"font-size: 19px; line-height: 200%;\"> 2</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">、部分患者为保持残余尿量不愿多透。患者充分认识到高血压的危害，饮食上限制盐的摄入（</span><span style=\"font-size: 19px; line-height: 200%;\">2-3</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">克</span><span style=\"font-size: 19px; line-height: 200%;\">/</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">天），限制水摄入，尽量使每日体重上升不超过</span><span style=\"font-size: 19px; line-height: 200%;\">1</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">公斤。过多的水分应当透析时尽量清除，因为残余尿量的保持是以增加心血管系统的负荷为代价的，应当主动配合医生评价并逐渐达到干体重。必要时可以请医生协助调整透析液钠浓度或改变透析剂量、模式。</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">&nbsp;&nbsp;</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">当然药物治疗也非常重要，但是应当记住降压不能只靠吃药，药物治疗不是降压治疗的全部，健康生活方式应当贯彻一生。<strong>尿毒症透析</strong>的患者朋友应当注意几个用药的细节问题：</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">1</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">、应当规律用药，坚持终身治疗；</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">2</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">、尽量选用长效药物；</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">3</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">、按照血压波动规律服药，降压药应该在高峰到来之前服用，即早起后和下午</span><span style=\"font-size: 19px; line-height: 200%;\">4-5</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">点服药最好；</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">4</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">、吃药别忘了测血压；</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">5</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">、没有症状也要吃药，高血压治疗应依据病人的血压水平，而不是症状的有无或轻重。</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">&nbsp;&nbsp;</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">几种常用药物的使用注意事项：洛汀新、蒙诺：有良好的心脏保护作用、降压平稳，部分患者可能造成血钾；洛活喜：长效药物，效果肯定，降压平稳，副作用小；缓释异博定：作用强大，长效，但有可能导致心动过缓、心衰，使用中应当监测脉搏；倍他乐克：虽然降压作用较弱，但有心脏保护作用，长期服用效果好，有可能降低心率，注意监测脉搏，不宜突然停药，否则心率加快；心痛定：短效药物、血压波动大，可以短期服用，不宜作为长期用药依赖；哌唑嗪：效果短暂，可能造成体位性低血压，在生活中体位变动应当注意，避免晕倒。</span></p>\n<p>&nbsp;</p>","barId":"1696","topicTypeId":"1","topicThemeId":"1015","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":1793,"score":0,"partCount":0,"replayCount":0,"publishStatus":1,"publishTime":1503059887843,"isCream":0,"canReply":0,"shareUrl":null,"foodCouponVal":1,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":1503059887843,"metaSearch":null,"rn":null},"userAllInfo":{"id":null,"isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"username":null,"password":null,"level":0,"nickName":null,"realName":null,"signName":null,"head":null,"phone":null,"mobile":null,"wechat":null,"qq":null,"email":null,"address":null,"identityType":0,"userType":0,"isPhoneBind":0,"status":0,"accountSource":0,"isStrangerMsg":0,"departmentId":null,"departmentName":null,"sex":0,"provinceId":null,"cityId":null,"userLevel":0,"modifyNameCount":0,"forumUser":{"id":"b1a5ca4ddfad11e6a61c00163e04584d","isDel":0,"createAt":1484984778320,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"username":"小海螺","password":"yiren2921","level":0,"nickName":"小海螺78","realName":null,"signName":"开心每一天","head":"http://01luntan.com/ly_img/1484985295689.jpg","phone":null,"mobile":null,"wechat":null,"qq":null,"email":"2276635444@qq.com","address":null,"identityType":6,"userType":2,"isPhoneBind":0,"status":0,"accountSource":0,"isStrangerMsg":0,"departmentId":null,"departmentName":null,"sex":1,"provinceId":"110000","cityId":"110108","userLevel":0,"modifyNameCount":1},"forumUserActiveInfo":{"id":"b1ba5254dfad11e6a61c00163e04584d","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":1705892489293,"updateBy":"b1a5ca4ddfad11e6a61c00163e04584d","updateName":"小海螺","userId":"b1a5ca4ddfad11e6a61c00163e04584d","topicCount":2201,"replayCount":900,"favorteCount":0,"beFavorteCount":0,"creamCount":2,"focusCount":1,"fansCount":4,"integralCount":2357,"foodCouponCount":0,"lastLoginTime":0,"lastLoginIp":null,"downloadCount":0,"uploadCount":0},"newPass":null,"focusBar":null,"counter":null,"forumUserIdentificateDto":null},"theme":{"id":"1015","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"topicTypeId":"1","topicTypeName":"资讯","themeName":"专家观点","barType":"101","schemaName":2,"reward":0},"page":1,"favorties":true,"isSelf":false,"order":"asc"}