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Jingdong book

临床诊疗指南·小儿内科分册

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Books Medical Science Pediatrics

Jingdong book

临床诊疗指南·小儿内科分册

Name: 临床诊疗指南·小儿内科分册
Brand: Jingdong book
SKU: 3117040791
Price: 33.73 USD
Availability: OutOfStock

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《临床诊疗指南·小儿内科分册》系由中华人民共和国卫生部委托中华医学会儿科学分会组织全国知名专家编写。内容包括儿童保健、儿科各系统主要疾病的临床表现、诊断要点及治疗原则，并附儿科常用药物及其剂量。
本书内容丰富、实用性强。可供儿科临床医师应用。

Catalogue

第一章儿童保健及生长发育
第一节儿童保健管理
第二节生长发育
第三节休格检查
第四节神经-心理发育检查
第五节计划免疫
第六节听力保健
第七节口腔保健
第八节眼保健
第二章营养障碍性疾病
第一节儿童营养障碍
第二节婴儿喂养不良
第三节单纯肥胖症
第四节维生素A缺乏病
第五节维生素D缺乏病
第六节碘缺乏
第三章新生儿疾病
第一节新生儿窒息
第二节新生儿呼吸暂停
第三节新生儿湿肺
第四节新生儿肺透明膜病
第五节胎粪吸入综合征
第六节新生儿感染性肺炎
第七节新生我肺出血
第八节气漏综合征
第九节早产儿慢性肺疾病
第十节新生儿惊厥
第十一节新生儿缺氧缺血性脑病
第十二章新生儿颅内出血
第十三章新生儿黄疸
第十四节新生儿贫血
第十五节新生儿出血病
第十六节新生儿红细胞增多症
第十七节早产儿动脉导管未闭
第十八节新生儿持续肺动脉高压
第十九节新生儿呕吐
第二十节新生儿坏死性小肠结肠炎
第二十一节新生儿败血症
第二十二节新生儿化脓性脑膜炎
第二十三节新生儿先休克
第二十四节新生儿先天性感染
第二十五节新生儿低血糖症
第二十六节新生儿高血糖症
第二十七节新生儿低钙血症
第二十八节新生儿寒冷损伤综合征
第二十九节低出生体重儿的主要问题
第四章遗传性疾病
第五章免疫及变态反应性疾病
第六章感染性疾病
第七章结核病
第八章消化系统疾病
第九章呼吸系统疾病
第十章循环系统疾病
第十一章泌尿系统疾病
第十二章血液系统疾病
第十三章神经系统疾病
第十四章内分泌系统疾病
第十五章儿科急症与危重症
附录：儿科常用药物及剂量

Book Abstract

第十一节溶血尿毒综合征
溶血尿毒综合征（hemolytic uremic syndrome，HUS）是由多种原因引起的一组疾病。其共同的临床表现为溶血、血小板减少和急性肾衰竭等。典型HUS与细菌、病毒感染有关。其中与能产生志贺菌样毒素（SLTs）的大肠杆菌O157：H7、志贺痢疾杆菌关系最为密切。起病时常有严重胃肠道症状，并可流行。非典型病例常为散发，无胃肠道症状，多属常染色体显性或隐性遗传，同一家庭中可有其他成员发病，且有复发倾向，预后差。
【临床表现】
1．前驱病多数为胃肠炎，表现为发热、呕吐、腹痛和腹泻，可伴血便。非典型病例无前驱病，但可有家族史，尤其同胞发病。
2．症状与体征于前驱病5～10天后突然起病，出现苍白、烦躁、乏力、嗜睡、少尿或无尿、高血压、皮下和黏膜出血。可有脱水或水肿、黄疸和肝脾肿大等。严重病例发生抽搐和昏迷。
【诊断要点】
1．有以上临床表现。
2．血管内溶血实验室证据贫血并进行性加重，网织红细胞中度增多，红细胞大小不等、嗜多染色、呈三角形、芒刺形或盔帽状。
3．血小板减少常低于100×109/L，一般持续7～10天，然后逐渐回升。
4．肾衰竭诊断标准参见肾衰竭节。
5．尿液检查轻度蛋白尿、镜下血尿、血红蛋白尿和各种管型。
6．肾穿刺活组织检查 HUS多数可临床诊断，毋须肾活检。当临床诊断有困难时，可行肾活检。病理特征为小血管内皮损伤和血栓形成。
【治疗】
1．治疗急性肾衰竭参阅急性肾衰竭节，尽早采用透析治疗。
2．纠正贫血当外周血血红蛋白<60g/L可输新鲜洗涤压积红细胞，输入速度宜慢。
3．抗凝治疗用于早期高凝状态，可用肝素、血小板凝聚抑制剂（如双嘧达莫）、小剂量阿司匹林1～3mg/（kg·d）。
4．纤溶疗法可用去纤苷（defibrotide）或尿激酶。
5．输注新鲜冰冻血浆用于非典型病例。
6．其他治疗血浆置换、依前列醇（前列环素、PGI2）和大剂量免疫球蛋白静注等按条件选用。
第十二节急性肾衰竭
急性肾衰竭（acute renal failure）是指肾脏在各种致病因子作用下短期内肾功能急剧降低，甚至完全丧失，临床表现为水电解质紊乱、酸中毒和氮质血症等。尿量显著减少或无尿是急性肾衰竭突出的临床表现，但部分患儿尿量可以不少，被称为非少尿性急性肾衰竭。
急性肾衰竭就其病因和病理生理可分为肾前性、肾实质性和肾后性三型。
【临床表现】
急性肾衰竭临床经过可分为三期，临床表现如下。
1．少尿期少尿或无尿，伴氮质血症，水过多（体重增加、水肿、高血压、肺水肿、脑水肿），电解质紊乱（如高钾血症、低钠血症、高磷血症、低钙血症，少数呈现低钾血症），代谢性酸中毒，并可出现循环系统、神经系统、呼吸系统和血液系统等多系统受累的表现，
2．利尿期尿量逐渐或阶段性或急剧增多（每天超过250ml／m2），浮肿有所减轻，但氮质血症未消失，甚至可能继续轻度升高，可伴有水电解质紊乱等表现。
3．恢复期氮质血症基本恢复，贫血改善，而肾小管的浓缩功能恢复缓慢，约需数月之久。
……

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Jingdong book

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