症状和体征 Symptoms and signs 口渴,皮肤干燥 Thirst, Dry skin and mucose 体重下降 Weight loss 体位性低血压 Orthostatic hypotension 心动过速 Tachcardia 平卧时颈静脉塌陷 Flat neck vein 逸大 liiipllwwsrrsh. com
http//www.srrsh.com 症状和体征 Symptoms and signs • 口渴，皮肤干燥Thirst , Dry skin and mucose • 体重下降Weight loss . • 体位性低血压Orthostatic hypotension • 心动过速 Tachcardia , • 平卧时颈静脉塌陷 Flat neck vein • 少尿 Oliguria
实验室 Laboratory Tests 血液浓缩(白蛋白,血球压积), Hemoconcentration 尿比重>1.030, Urine specific gravity>1.030 尿渗透压>500mosm/kgH2O, Urine osmolality >500mosm/kgh20 尿钠<20mEq/, Urine sodium<20mEqL 血尿素氮/血肌酐>20BNU/Scr>20, °钠排泄系数(FENa)<1% Fractional excretion of sodium<1%o UNa pcr FENa= 100 小逸大医 liiipllwwsrrsh. com
http//www.srrsh.com 实验室Laboratory Tests •血液浓缩（白蛋白，血球压积），Hemoconcentration •尿比重>1.030, Urine specific gravity>1.030 •尿渗透压>500mosm/kgH2O, Urine osmolality >500mOsm/kgH2O •尿钠<20mEq/l, Urine sodium<20mEq/L •血尿素氮/血肌酐>20 BNU/Scr>20 , •钠排泄系数（FENa）<1% Fractional excretion of sodium<1% UNa Pcr FENa= —— × 100% PNa Ucr
特殊检查 Special monitoring 中心静脉压 Low central venous pressure 肺毛细血管嵌合压 Low pulmonary wedge pressure 心搏出量 Low Cardiac output 逸大 liiipllwwsrrsh. com
http//www.srrsh.com 特殊检查Special monitoring 中心静脉压Low central venous pressure 肺毛细血管嵌合压Low pulmonary wedge pressure 心搏出量Low Cardiac output
处理 Management 病因处理 Correct the underlying disorder 扩容 Volume replacement 生理盐水或5%葡萄糖液200 500ml/ivgtt 30-60min 老年和或心功能不全病人:100 50m/hr。补液时注意CVP和心功能 100-150mW/hr in the elder and/or cardiovascular status is tenuous 小逸大医 liiipllwwsrrsh. com
http//www.srrsh.com 处理 Management • 病因处理Correct the underlying disorder • 扩容Volume replacement 生理盐水或5％葡萄糖液200－ 500ml/ivgtt 30-60min • 老年和/或心功能不全病人：100- 50ml/hr。 补液时注意CVP和心功能 100-150ml/hr in the elder and/or cardiovascular status is tenuous
扩容后利尿 Diuresis must be avoid before fluid replacement 甘露醇25g静滴 Mannitol25g/ iv gtt 速尿100mg(200mg)静注 Furosemide 100mg/iv(200mg) 逸大 liiipllwwsrrsh. com
http//www.srrsh.com 扩容后利尿 Diuresis must be avoid before fluid replacement 甘露醇25g静滴Mannitol 25g/iv gtt 速尿100mg（200mg）静注Furosemide 100mg/iv ( 200mg)