摘要
目的观察抑肽酶对肾移植手术病人术中出血量、手术时间、术后引流量、尿量和移植肾肾功能的影响，探讨抑肽酶在肾移植术中应用的可行性和安全性。方法60例肾移植手术患者，随机分成抑肽酶组（A组）和对照组（C组），每组30例。观察术中出血量、手术时间、术后第1、2、3天引流量，术后5d每天尿量和肾功能（血清尿素氮、血肌酐），计算血清肌酐降至正常范围（150umol／L）的平均时间。结果①术中出血量、术后3d引流量：A组明显少于C组（P〈0．01），手术时间A组明显短于C组（P〈0．05）；②两组病人术后第1、2天尿量比较差异有统计学意义（P〈0．05），之后每天尿量差异无统计学意义（P〉0．05）；③血清肌酐降至正常范围（150umol／L）所需要的平均时间：A组为（6．1±1．5）d，C组为（5．9±1．7）d，二者比较差异无统计学意义（P〉0．05）。结论抑肽酶可以明显减少肾移植手术病人术中出血量、术后引流量，缩短手术时间，虽然对肾移植病人术后早期的尿量可能有一定的影响，但仍可安全用于肾移植手术。
Objective To investigate the feasibility and safety of aprotinin in kidney transplantation through observing the amount of intraoperative blood loss, postoperative drain and the change of renal function. Methods Sixty patients with chronic renal failure undergoing kidney transplantation were studied. Thirty -three patients were male and twenty -seven were female. M1 the patients received combined spinal -epidural anesthesia （CSEA） and were randomly divided into two groups： aprotinin group （group A, n = 30 ） and control group （group C, n = 30）. The measured variables included the amount of intraoperative blood loss, postoperative drain on the 1st,2nd and 3 rd day after operation, total urine output, creatinine and urea nitrogen from the 1st to 5th day after operation and the mean time of urea nitrogen down to normal level（ 150 ummol/L）. Results There was no significant difference in preoperative data （ age, sex, weight, hemoglobin and platelet count） between two groups. The amount of intraoperative blood loss in group A was significantly reduced [ （ 109 ± 12） ml vs （204± 14）ml, P 〈0.01 ], and postoperative drain was also reduced significantly on the lst,2nd and 3 rd day [（56.2±10. 1）ml vs （216.2 ± 12）ml, P 〈0.01; （35.1 ±5.4）ml vs （79.3 ±6.8）ml, P 〈0.01; （13.1 ±2.0）ml vs （28.6 ±3.7）ml, P 〈0.05]. The mean time of urea nitrogen down to normal level was no signifieant differenee between two groups [ （6.1 ± 1.5 ） d vs （5.9 ± 1.7 ） d, P 〉 0.05 ]. The total urine output on the 1st to 2nd day after operation in group A was signifieantly redueed [ （7526 ±216）ml vs （11585 ± 158）ml, P 〈 0.01; （7459 ± 198）ml vs （9475 ± 177）ml, P 〈 0.05 ], but there was no signifieant differenee between two groups from the third day （ P 〉 0.05）. Conclusion Aprotinin ean signifieantly reduee the amount of perioperative blood loss and postoperative drain in patients undergoing kidney transplantation. Although it has adverse effeets on transplanted renal funetion , it＇s safe in kidney transplantation.
出处
《中原医刊》
2007年第8期29-31,共3页
Central Plains Medical Journal
关键词
抑肽酶
肾脏移植术
麻醉
Aprotinin
Kidney transplantation
Anesthesia
