最後更新:2026年10月1日
腎梗塞是腎動脈或其分支血流中斷導致的腎組織缺血性壞死。通常由血栓栓塞引起,可為局灶性或彌漫性,是多種全身性疾病的併發症。
貓腎梗塞可與心臟病相關的動脈血栓栓塞 (ATE) 同時發生,但以後肢動脈栓塞更常見。
犬腎梗塞多與高凝狀態相關,如蛋白喪失性腎病、腎上腺皮質功能亢進、免疫介導溶血性貧血等。常為屍檢偶然發現。
急性期抗凝血治療,防止血栓延伸並維持腎臟殘餘血流灌注
鈣通道阻斷劑,管理腎素-血管緊張素系統活化導致的全身性高血壓,保護殘餘腎功能
建議:0.9% NaCl 或 LRS,矯正脫水後以 2× 維持量支持 post-obstructive diuresis
類型:0.9% NaCl
監測頻率:每日觀察
[1]An Unusual Vascular Catastrophe: Atheromatous Aortic Dissection With Renal Artery Thrombosis and Cortical Laminar Necrosis Post Cerebral Ischemia.
[2]Q Fever Endocarditis Presenting with Superior Mesenteric Artery Embolism and Renal Infarction.
[3]"Isolated Spontaneous Renal Artery Thrombosis - A Rare Cause of Acute Flank Pain".
[4]A new low-nephron CKD model with hypertension, progressive decline of renal function, and enhanced inflammation in C57BL/6 mice.
[5]Adipose tissue derived mesenchymal stem cell transplantation in the treatment of ischemia/reperfusion induced acute kidney injury in rats. Application route and therapeutic window1.
[6]Consensus Recommendations for Standard Therapy of Glomerular Disease in Dogs
建議數日內就診評估,非立即危及生命但不宜拖延 (evaluation within days recommended, not immediately life-threatening)
預後取決於梗塞範圍與潛在病因。單側局灶性梗塞預後良好,對側腎臟可代償。雙側大面積梗塞或潛在病因無法控制者預後不良。需長期抗血栓治療預防復發。
腎梗塞 診斷流程
評估急性腎臟疼痛和潛在栓塞來源
進行腎功能和凝血評估
進行腎臟超音波和都卜勒評估
調查血栓栓塞的來源
來源:專家審閱