目的 探讨手术后毛细血管渗漏综合征(CLS)并急性肾损伤的临床特点及治疗方法.方法 6例外科手术后CLS合并急性肾损伤患者,采用液体复苏、糖皮质激素和连续性静脉-静脉血液滤过(CVVH)治疗.结果 术后血浆白蛋白浓度20.32±1.35g/L较术前34.68±3.80g/L显著降低(P＜0.05)；术后血肌酐206.90±120.60μ mol/L较术前90.02±24.85μ mol/L 显著升高(P＜0.05).治疗后4例患者肾功能和血浆白蛋白恢复正常；1例发展为慢性肾衰竭；1例死于多器官功能衰竭.结论 外科手术后不明原因白蛋白降低需警惕CLS发生,早期血液净化和胶体复苏治疗可提高救治成功率.%Objective To explore the clinical features and management in patients with post - operative capillary leak syndrome ( CLS) complicating acute kidney injury. Methods Clinical data of 6 patients with post - operative CLS complicating acute kidney injury was analyzed. Results Postoperative serum albumin concentration was significantly lower than preoperative value (20. 32 ± 1. 35g/L vs 34.68 ±3. 80g/L, P <0.05). Postoperative concentration of serum creatinine was significantly higher than preoperative data (206.90 ± 120. 60 μmol/L vs 90. 02 ± 24. 85 μmol/L, P < 0. 05 ) . After an intensive therapy with fluid resuscitation, glucocorticoid and continuous veno - venous hemofiltration (CVVH) , 4 patients recovered in renal function and serum albumin, 1 case developed chronic renal failure and 1 case died of multiple organ failure. Conclusion CLS may be responsible for the post - operative decrease of serum albumin and early blood purification and colloid resuscitation may improve the prognosis of the condition.
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