摘要
报道梗阻性黄鱼合并胆汁性肾病（ＣＮ）３４例，术后死亡率２９．４％，急性肾功能衰竭（ＡＲＦ）发 生率４１．２％，ＡＲＦ死亡率为７１．４％。作者探讨了ＣＮ患者麻醉处理与术后ＡＲＦ关系，认为ＣＮ是术后 ＡＲＦ发生率和死亡率增高的病理基础，肾功能处于ＡＲＦ的前兆，麻醉手术有一定的危险性，ＡＲＦ发生 率与黄疸程度、麻醉方法和低血压持续时间有关。ＣＮ患者选择全麻优于连续硬膜外阻滞，对于重度黄疸 （和）或伴有感染性休克者应首选全麻。正确的麻醉处理是防止和减少术后ＡＲＦ的关键。
Anesthetic experiences of 34 patients with the operation on cholemic nephrosis (CN ) for benign obstruction of binary tract were reported. After operation, the incidence rate of ARF was 41.2% . Total mortality was 29. 4 %,in which the mortality of ARF in this series was 71. 4%. The anesthetic management and postoperative ARF were discussed. There are close relation between the incidence of ARF and the degree of the ieterus. The pathological changes of CN are reversible, which would be reversed after the relief of the cholangiolar or choledochal obstruction. Conversely, the renal function may be worse and become irreversible due to the harmful actions of anesthesia and operation. Preexistant CN is the pathologic basis of the augmentatio of the incidence rate and the mortality of the postop- erative ARF. There are certain dangers to perform anesthesia and operation on patient with CN. A correct anesthetic management is the key to the prevention or reduction of the occurrence of postoperative ARF.
出处
《中华麻醉学杂志》
CSCD
北大核心
1994年第5期355-357,共3页
Chinese Journal of Anesthesiology
关键词
胆汁性肾病
麻醉
肾功能衰竭
Cholemic nephrosis Anesthesia Acute renal failure
