摘要
目的探讨心脏术后急性肾功能衰竭的治疗方法。方法回顾性分析广西梧州市红十字会医院心脏手术患者538例中术后发生急性肾功能衰竭21例的临床资料。其中,法洛四联症4例,感染性心内膜炎并主动脉瓣关闭不全7例,风湿性心脏病瓣膜置换10例。出现少尿型肾功能衰竭17例,非少尿型肾功能衰竭4例;非少尿型肾功能衰竭4例患者采取合理输液治疗,少尿型肾功能衰竭17例中4例采用腹膜透析及13例采用血液透析治疗。结果21例中14例治愈,7例死亡患者为少尿型肾功能衰竭合并有多脏器功能衰竭院内死亡,6例主要死亡原因为肾功能衰竭合并心力衰竭和肺部感染呼吸衰竭死亡,1例合并真菌性败血症。7例死亡患者中1例为法洛四联症患者、2例为感染性心内膜炎瓣膜置换术患者、4例为风湿性心脏病瓣膜置换术患者。结论心脏术后急性肾功能衰竭要早期发现、及时处理,加强利尿等方法无效时,及时进行腹膜透析或血液透析。
Objectives To evaluate the treatment effect of acute renal failure （ARF） in patients after cardiac surgery. Methods Retrospective clinic data on 538 patients undergoing cardiac surgery in Wuzhou Red Cross Hospital were investigated. Of them, 21 patients were with ARF： 4 cases of tetralogy of Fallot, 7 cases of aortic regurgitation due to infective endocarditis and 10 cases of rheumatic heart valve replacement. Among them, 17 cases turned to oliguric renal failure and 4 cases turned to non-oliguric renal failure. These 4 patients with non-oliguric renal failure received a reasonable transfusion therapy;while of the other 17 patients with oliguric renal failure,4 cases were treated with peritoneal dialysis and 13 cases were treated with hemodialysis treatment. Results Fourteen patients were cured and 7 patients died. The 7 patients died from oliguric renal failure complicated with multiple organ failure. The main causes in the 6 cases were renal failure with heart failure and pulmonary infection with respiratory failure, and infection combined with fungal septicemia in 1 case. The 7 death cases included 1 case of tetralogy of Fallot, 2 cases of valve replacement with infective endocarditis and 4 cases of valve replacement with rheumatic heart disease. Conclusions Early diagnosis and treatment can significantly improve the curative effect. When strengthening diuretic and other treatment are unavailable, peritoneal dialysis or hemodialysis in time is an effective method to treat ARF after cardiac surgery, and should starts as early as possible.
出处
《岭南心血管病杂志》
2013年第4期460-462,522,共4页
South China Journal of Cardiovascular Diseases
