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摘要：本文以临床一例猫肥厚性心肌病并发肾衰的病例为研究对象，探讨了对该病的诊断和治疗方法，旨在为宠物医院提供相关心肾综合征的临床诊治指导经验。对该病例先后采用血液常规检查、血液生化检查、X 光检查、超声检查等多种手段进行诊断，依次诊断出肺水肿、肥厚性心肌病和慢性肾衰。前期治疗使用利尿剂和血管扩张剂，肺水肿症状和肥厚性心肌病的治疗效果明显，但后期在肾衰的治疗上因补液等治疗没能充分的实施以及主人的对肾衰治疗的忽视，导致病情快速恶化，最终死亡。本病诊断准确而严谨，治疗充分考虑各方面的因素，整个病例的诊治过程均值得借鉴。心肾综合征的防治需要早发现早治疗，综合评估两个脏器的功能情况来制定联合治疗的原则，除此之外尤其需要宠物主人的积极配合。37981
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毕业论文关键词：肥厚性心肌病；肾脏衰竭；心肾综合征
Diagnosis and Treatment of Cat Hypertrophic CardiomyopathyComplicated with Renal Failure
Abstract： This article probed into the diagnosis and treatment method of a clinic case about cathypertrophic cardiomyopathy complicated with renal failure in order to provide reference for pet medicaltreatment. The cat was diagnosed with pulmonary edema, hypertrophic cardiomyopathy, and chronic renalfailure, in turn, by successively utilizing blood routine examination, blood biochemical examination, X-rayexamination, a variety of means such as ultrasound diagnosis. Using of diuretics and vasodilator in earlytreatment, the treatment of pulmonary edema and hypertrophic cardiomyopathy effect was obvious. Butlater on in the treatment of renal failure by fluid replacement therapy was not able to fully implement andthe cat’s master neglected of treatment of renal failure, which both lead to rapid deterioration, the cat waseventually died. In the case, the diagnosis was accurate and precise, the treatment was based on fully takinginto account all aspects of the factors, the whole process of diagnosis and treatment of cases were worthusing for reference. Cardiorenal Syndrome need to be found early and to be treated early. Overall evaluatetwo viscera functions to formulate the principles of combination therapy. In addition, in particular, petowners need to actively cooperate with veterinarian.
Key words: Hypertrophic Myocardial Diseases; Renal Failure; Cardiorenal Syndrome
目录
摘要1
关键词1
Abstract1
Keywords1
引言2
1材料与方法2
1.1材料2
1.1.1病例来源2
1.1.2设备2
1.1.3药品2
1.2诊疗过程2
1.2.1病例资料登记2
1.2.2病史2
1.2.3初诊2
1.2.4确诊肥厚性心肌病4
1.2.5确诊并发慢性肾衰5
1.2.6转归8
2结果与分析8
2.1病因分析8
2.2肥厚性心肌病的诊治9
2.2.1诊断9
2.2.2治疗9
2.3肾衰的诊治9
2.3.1诊断9
2.3.2治疗9
2.4死亡原因分析9
3讨论10
3.1心脏病的诊断方法10
3.1.1X光检查10
3.1.2超声心动图检查10
3.1.3心电图检查10
3.2心肾综合征的的治疗方法10
3.2.1治疗原则10
3.2.2食疗10
3.3心肾综合征的预防10
3.3.1加强对心脏和肾脏疾病的预防10
3.3.2心/肾功能异常时加强对另一者的监测11
3.3.3治疗心/肾疾病时加强对另一者的保护11
3.3.4注重心肾综合征的早期治疗11
致谢11
参考文献11
猫的心肌病包括一系列影响猫咪心脏功能的疾病，其中肥厚性心肌病（Hypertrophic Myocardial Diseases, HCM）在临床上最为常见。该病的发病原因尚未研究清楚，但有些病例的病因被认为存在一定的基因遗传因素影响。其中某些品种的猫咪，如加菲猫、波斯猫、布偶猫等更加容易患病，其中中年公猫更为多发[1]。患猫常出现呼吸急促，呼吸困难等呼吸道症状，发生肺水肿，听诊出现明显的呼吸音和心脏收缩期杂音。器官病变主要表现为左心室壁的肥厚。慢性肾功能衰竭(Chronic Renal Failure, CRF)是肾功能单位不断受损，肾脏发生器质性的改变，产生了不可逆性的损害，导致肾脏功能的衰竭。病发常见于老年犬猫。临床特征包括体重下降，贫血，尿比重下降，肾脏体积缩小等[2]。急性肾衰（Acute renalfailure， ARF） 是由于肾脏突然的局部缺血或毒物等因素造成的急性损伤而导致的肾衰。临床症状包括精神沉郁，呕吐，腹泻，脱水和氮质血症等症状。本病是一例典型的心肾综合征（Cardiorenal Syndrome, CRS）的病例。心脏或肾脏原发性的衰竭引起或加重了另一脏器的衰竭，对原发脏器疾病的治疗也会引起另一脏器的功能损伤[3]。通过对本例病例诊治过程的跟踪记录，对这一个病例的诊断和治疗过程进行总结，汲取其中值得借鉴的诊疗手段，改进尚有不足的方面，为日后临床上对宠物心肾综合征的诊治提供经验和指导。