摘要
目的探讨术前放置主动脉内球囊反搏（IABP）对体外循环下心脏手术患者围手术期的肾功能保护作用。方法2010年5月至2012年5月，选取术前合并中度肾功能不全的体外循环心脏手术患者17例，数字表法随机分成2组，IABP组于麻醉后即置入IABP辅助循环，主动脉阻断期间使用内置模式继续反搏，直至术后血流动力学稳定、肾功能好转后逐渐撤除。对照组围手术期不使用IABP。记录并比较2组患者围手术期肾功能变化及恢复情况。结果IABP组体外循环期间的尿量、术后利尿剂用量、机械通气时间等指标显著优于对照组。所有患者术后血清肌酐水平（SCr）均有明显升高，但IABP组在各时间点的SCr水平均显著低于对照组，且恢复更快。结论合并中度以上慢性肾功能不全的患者，体外循环心脏手术围手术期积极地、预防性使用IABP可显著减少急性肾损伤的发生，明显改善预后。
Objective To discuss the protective effect of intra-aortic balloon pump（IABP） on renal function in patients with chronic renal insufficiency undergoing cardiac operations. Methods From May 2010 to May 2012, 17 patients with moderale renal insufficiency who underwent cardiac surgery using cardiac pulmonary bypass（CPB） were randomized to divide into IABP group and control group. IABP was inserted before the cardiac operation, the support was maintained perioperatively in IABP group. In control group the IABP was never used during the operation. The clinical parameters related to renal function including the output of mine, the serum creatinine levels were documented perioperatively. Results The serum creatinine lev- els were increased obviously post-operation in both groups. But the degree of increase was significantly smaller in IABP group. Conclusion To patients with moderate renal insufficiency undergoing CPB cardiac operations, perioperative application of IABP is beneficial to protect renal function and may help to improve the outcome.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
2013年第9期522-524,共3页
Chinese Journal of Thoracic and Cardiovascular Surgery
