摘要
目的总结心脏手术后急性肾损伤(CAS-AKI)的治疗经验。方法回顾性分析我院2009年1月—2016年7月收治的9例原位心脏移植术后发生AKI的患者临床资料,其中3例应用大剂量利尿剂(呋塞米>80 mg/d)治疗,6例行连续性肾脏替代治疗(CRRT)。比较心脏移植术前、术后及AKI治疗后患者血肌酐(Cr)及估测肾小球滤过率(e GFR)变化,观察患者围术期的生存质量。结果经过利尿剂或CRRT治疗后,患者总体血Cr水平下降,e GFR水平升高,肾功能有所恢复。经利尿剂治疗的患者e GFR恢复效果优于CRRT者。结论 CSA-AKI发生后应根据患者的严重程度采取综合治疗,减轻肾功能损伤。
Objective To summarize the treatment experiences in patients with cardiac surgery- associated acutekidney injury（CSA- AKI）. Methods The clinical data of 9 patients with acute renal injury after orthotopic hearttransplantation in our hospital from January 2009 to July 2016 were retrospectively analyzed. Three patients were requiredthe high- dose diuretics（furosemide, 〉80 mg/d） and six patients were received continuous renal replacement therapy（CRRT）. The levels of serum creatinine（Cr） and estimated glomerular filtration rate（e GFR） were compared before and afterheart transplantation and after the treatment of AKI. The quality of life was observed in patients in perioperative period.Results After the treatment of diuretics or CRRT, patients showed renal function recovery with significant decreased Crlevels and increased e GFR compared with the postoperation. The patients with diuretic therapy revealed a better e GFRrecovery than those with CRRT. Conclusion CSA-AKI should be based on the severity of disease, and comprehensivetreatment should be taken to reduce renal damage.
出处
《天津医药》
CAS
2017年第1期51-53,共3页
Tianjin Medical Journal
关键词
心脏移植
手术期间
肾功能衰竭
急性
围术期
利尿药
肾小球滤过率
持续血液滤过
肌酐
heart transplantation
intraoperative period
kidney failure
acute
perioperative period
diuretics
glomerular filtration rate
continuous renal replacement therapy
creatinine
