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Current location: China paper Ce Medi Clin body left upper limb fracture after head trauma patients with intracranial hematoma and renal urinary tract infection before the diagnosis and treatment of oliguria
China paper Center [ ] Editor: studa20
Admission examination: blood Rt, BUN, CO2CP serum creatinine, electrolytes, protein electrophoresis, erythrocyte sedimentation rate. At present, the patient can not eat, nor the urine, so strict control of fluid intake, to ensure that 1000 ml of liquid a day or so. Lobeline 6ml adding 5% G.N.S 500ml of static points. Fluid intake 2250 ml, urine volume 2000 ml, potassium 1 g (plus 500 ml) intravenous solution, with 5% sodium bicarbonate (NB) 250 ml of static points.

Treatment guidelines: strengthening the nursing, infection control, symptomatic treatment. 100 ml twice uremic Ling Chinese / d enema, low-flow oxygen, intermittent cough, oral care. After the urine increased after treatment to brain surgery. After treatment, his condition improved, the patient's family asked hospital.
2 Discussion
The patient was middle-aged men, due to trauma, the occurrence of left upper limb fractures, head trauma, intracranial hematomas after admission. A variety of traumatic crush injury-prone syndrome, the patient is trauma patients, in addition to fracture and brain injury caused by external compression should pay attention to whether the admission was considered oliguric ARF of crush syndrome. Urinary tract infections, mainly based on clinical and laboratory examination, bacterial culture with bacterial growth. Added potassium chloride, sodium bicarbonate, to maintain water and electrolyte acid-base balance is necessary. In the prevention of brain infection, treatment and easy use through the blood-brain barrier after renal toxic side effects of antibiotics, anti-infection and prevent infection fracture benefit. Chinese Huoxuezhitong powder can significantly improve the fracture swelling, and easy to use and safe.
A variety of head trauma, and renal dysfunction after surgery may not only need to pay attention to local lesions, but also should pay attention to the body without hemophilia, the latter can not be surgery.

carefully by the detailed history of left upper limb X-ray confirmed fracture, you do not check whether with or without bone rubbing bone fricative being and to avoid the examination of patients with pain when the injury increased, the typical visible fractures were shortened or deformed limb , swelling and bleeding at the fracture site, palpation tenderness, need orthopedic specialist treatment. Some patients with prerenal ARF, because of severe trauma, burns, crush injuries, bleeding, surgery, vomiting, diarrhea, or diuretics caused a large number of applications, timely diagnosis and treatment.
After the failure of surgical treatment, nonunion of the humerus can be used Iizarov ring holder. Calcified hematoma is a correctable head, the presents a simple treatment cephalhematoma classification and algorithm. Incomplete calcification can head early hematoma aspiration and compression dressings. Calcified hematoma cause significant skull skull deformation, surgical treatment can be safely achieved excellent results. Spanish multicenter study focused on the establishment of acute renal failure in ICU subjects (acute kidney failure AKF) the incidence and prognosis. Adult patients pre-looking-depth study of 43 medical units in Spain's ICU families, a total of 901 cases occurred AKF, prerenal oliguria 29.9%. In the ICU patients AKF, a higher mortality rate. Huoxuezhitong powder can significantly improve the fracture surgery swelling, and easy to use. Tracheotomy, indication difficulty breathing, coma and not more than 48 h, to be on breathing machines, surgery. After suction required to shoot back, if necessary, inhalation and so on. Through nasal feeding, supplementary heat and an appropriate proportion of various nutrients.
Press Pathophysiology of acute renal failure can be divided into prerenal, renal and kidney after sex. Prerenal acute renal failure are common causes of hypovolemia (loss of body fluids, such as a variety of reasons and bleeding), effective arterial blood volume reduction and renal hemodynamics (including the contraction of renal arterioles or small renal arteries after ) and so on. Of oliguric patients from history, physical examination, except for secondary screening with prostate hyperplasia or prostate cancer, urethral stricture, bladder or urinary tract stones, but also pay attention to the permeability of mannitol induced reduction of urine when kidney. Therapeutic purposes is normal blood pressure as much as possible, always apply ACEI, and additional anti-hypertensive agents, including calcium channel blockers. and blockers, but useful for renal replacement therapy may help, but often (almost half of the patients) is only temporary. Major abdominal trauma and complicated surgical procedures, renal blood flow and glomerular filtration damage can lead to oliguria, anuria, acute renal disorders, and oliguria with acute kidney injury patients as well as oliguria of patients, the prognosis is worse. The timing of nutritional support, passage of nutrition, proper nutrition preparation and other factors are associated with organ function support and the treatment of primary disease are closely related.
Diagnosis of prerenal oliguria must be other than of oliguria after renal, urinary tract obstruction caused by a variety of reasons, such as bladder diverticula, bladder neck sclerosis, urinary retention, hydronephrosis, obstructive nephropathy, but also to eliminate the tumor stones . Should be based on the cause of obstruction, the incidence of renal damage and the degree of urgency, comprehensive treatment, the most important thing is to remove the obstruction, anti-infection treatment is very important. Take timely and appropriate nutritional support, methods and means of expanding from the traditional to the nutritional content of genomics and nutrition, proteomics, the need to add the major nutrients (macronutrients) and micro-nutrients (micronutrients). The former mainly includes water, glucose, fat emulsion and amino acids, the latter including the electrolyte, micro elements and trace elements. Had severe urinary tract infection should be actively anti-inflammatory treatment. A variety of urinary tract infection urinary tract obstruction is the most important predisposing factors, urinary tract obstruction, poor urine flow, bacteria difficult to wash clean, tissue pressure increases upper urinary tract obstruction, affecting the blood supply and the normal physiological function, obstruction above reduced resistance to urinary tract mucosa, prone to infection. Also, pay attention to renal papillary necrosis, renal abscess, sepsis complications. Except for urinary tuberculosis should be, to pay attention and be differentiated from urinary tuberculosis (which is a Class C infectious diseases, to avoid false diagnosis of tuberculosis inflammation, except to be caused by renal oliguria contrast agents, drug toxicity).
Patients suffering from various diseases, and sometimes need to use multiple drugs, the drug can interact, the result of drug interactions can enhance the role of drug, resulting in toxicity, but also the role of drugs can weaken or even disappear, so should be avoided Western drug incompatibility, duplicate drug. Should be more to learn, fine observation, more research and avoid adverse drug reactions. On the rare difficult cases, further study. For such patients, medical work as comprehensive and rigorous, and constantly updated sound and improving, so critical to obtain good results difficult cases. Links in the paper for


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