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Jingdong book

临床诊疗指南·肾脏病学分册

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Jingdong book

临床诊疗指南·肾脏病学分册

Name: 临床诊疗指南·肾脏病学分册
Brand: Jingdong book
SKU: 3117014121
Price: 33.01 USD
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《临床诊疗指南：肾脏病学分册》是在卫生部、中华医学会领导下，中华医学会肾脏病、学分会组织全国临床一线专家编写。全书共五十六章，分别对原发性、继发性肾小球疾病和肾间质疾病以及慢性肾衰竭及其并发症的临床表现、诊断要点和治疗尿则与方案进行了系统、详细阐述。《临床诊疗指南：肾脏病学分册》编写过程中，力求科学性、新颖性和实用性，参考了国内外肾脏疾病诊治指南、专冢共识和最新资料，与国际接轨，体现当今肾脏疾病先进的诊疗水平，从我国临床实际情况出发，符合国内肾脏疾病临床诊疗需求。本书对于规范、指导我国肾脏疾病的临床诊疗工作，具有重要参考价值。
《临床诊疗指南：肾脏病学分册》内容新颖、系统，科学规范，实用性强，是临床医生和相关医疗行政管理人员必备的参考书籍。

Catalogue

第一章急性肾炎综合征
第二章急进性肾炎综合征
第三章慢性肾炎综合征
第四章肾病综合征
第五章无症状血尿
第六章无症状蛋白尿
第七章微小病变型肾病
第八章局灶节段性肾小球硬化
第九章膜性肾病
第十章 IGA肾病
第十一章系膜增生性肾小球肾炎
第十二章毛细血管内增生性肾小球肾炎
第十三章膜增生性肾小球肾炎（附致密物沉积病）
第十四章新月体性肾炎（附G00dpasture综合征）
第十五章狼疮肾炎
第十六章过敏性紫癜肾炎
第十七章系统性血管炎肾损害
第十八章流行性出血热肾损害
第十九章乙肝病毒相关性肾炎（附丙肝病毒相关性肾炎）
第二十章 HIV相关性肾病
第二十一章肝肾综合征（附肝硬化相关性肾小球疾病）
第二十二章血栓性微血管病
第二十三章高血压肾损害
第二十四章缺血性肾病
第二十五章糖尿病肾病
第二十六章肥胖相关性肾病
第二十七章脂蛋白肾小球病
第二十八章肾淀粉样变
第二十九章多发性骨髓瘤肾损害
第三十章冷球蛋白血症肾损害
第三十一章 AIport综合征
第三十二章薄基膜肾病
第三十三章 Fabry病
第三十四章纤维样肾小球病
第三十五章妊娠高血压肾损害
第三十六章急性间质性肾炎
第三十七章慢性间质性肾炎
第三十八章马兜铃酸肾病
第三十九章尿酸性肾病
第四十章反流性肾病
第四十一章梗阻性肾病
第四十二章多囊肾病
第四十三章肾小管性酸中毒
第四十四章尿路感染
第四十五章肾结核
第四十六章尿路结石
第四十七章急性肾衰竭
第四十八章慢性肾衰竭（附慢性肾脏病）
第四十九章肾移植的内科问题
第五十章血液净化方式的选择及疗效评价
第五十一章肾性贫血
第五十二章矿物质和骨代谢异常
第五十三章慢性肾衰竭心血管并发症
第五十四章水电解质紊乱
第五十五章酸碱平衡失调
第五十六章慢性肾衰竭的用药原则和给药方法
附录

Book Abstract

（6）其他检查：患者心电图可出现传导阻滞、心肌损害等表现，高血钾时可出现T波高尖，脑水肿时可见视盘水肿，双肾B超可发现双侧肾脏增大等。
3.流行病学在本病流行季节、流行地区发病，或于发病前2个月内曾到疫区居住或逗留过；与本病宿主动物及其排泄物有直接或间接接触史，或有接触实验动物史。有上述病史及临床表现时应高度怀疑本病。
【治疗方案及原则】
本病发病机制未明，治疗上以对症支持及综合治疗为主。治疗的目的是：①抑制病毒复制；②调节免疫异常；③迅速纠正休克；④防治组织出血；⑤减少肾脏损害，纠正水电解质酸碱平衡紊乱。
1.发热期
（1）一般治疗：早期卧床休息，给高热量、高维生素的易消化饮食。
（2）液体疗法：早期成人一般补液量为1500ml左右，呕吐、腹泻者可酌情增加，尽量口服。发热后期（病程第3～4日）多有血液浓缩，应给予静脉补液。补液量参照体温、血液浓缩程度及血压情况，以平衡盐液为主兼顾热量补充。部分患者发热后期酸中毒症状重，有恶心、呕吐，应依照病情调整酸碱平衡，以维持体内环境相对稳定。发热后期，每日尿量少于1000ml以下时，可酌情应用利尿剂。
（3）抗病毒药物及免疫调节剂治疗：临床实验证实过去传统抗病毒治疗药物对此病无效。国外有报道指出整合素抗体也许有助于对肾综合征出血热的控制和治疗。在目前缺乏特效抗病毒药物的情况下，利巴韦林（病毒唑）、干扰素、聚肌胞、转移因子、植物血凝素、胸腺素等仍可试用。白细胞介素受体拮抗剂、TNF-a阻断剂、钙通道阻滞剂（维拉帕米等）以及早期应用中和氧自由基的药物（如还原型谷胱甘肽）均能够起到减轻肾综合征出血热病情的作用。
（4）对症处理：激素具有抗炎和保护血管壁的作用，并能稳定溶酶体膜，降低体温中枢对内源性致热原的敏感性等。早期应用对降热、减轻中毒症状均有一定效果。高热、中毒症状重者可选用氢化可的松，每日100～200mg，或地塞米松5～10mg，稀释后缓慢静脉滴注。
2.低血压期以积极补充血容量为主，针对微循环功能障碍、酸中毒、心功能不全等，进行相应治疗。
（1）补充血容量：早期、快速、适量补充血容量是治疗低血压休克的关键性措施。由于肾综合征出血热时血浆蛋白大量外渗，故给予足量胶体液尤其重要。收缩压低于100mmHg，或低于基础血压20mmHg，脉压小于26mmHg时，即应扩容补液。常用溶液为低分子右旋糖酐，有扩充血容量、提高血浆渗透压、抗血浆外渗、减少红细胞与血小板间的聚集、疏通微循环、改善组织灌注和渗透性利尿等作用。
（2）调整酸碱平衡：有酸中毒时可选用5%的碳酸氢钠溶液。
（3）强心剂的应用：血容量基本补足、酸碱失衡纠正之后，心率仍在140次／分以上者，可选用毛花苷C或毒毛花苷K增加心搏量。
……

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