体外循环术后肾损害原因及预后的回顾分析

Retrospective Analysis of the Reason and Prognosis for Renal Function Lesion after Extracorporeal Circulation

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摘要【目的】分析体外循环术后肾损害的原因 ,探讨其防治方法。【方法】对体外循环术后发生急性肾功能损害的 31例患者分为两组进行研究 :Ⅰ ,死亡组 2 4例 ,Ⅱ ,治愈组 7例。【结果】两组体外循环后肾功能都有一定程度的损伤 ,死亡组术后低心排的持续时间和严重程度明显高于治愈组 ,P <0 0 5。【结论】术后低心排可能是造成急性肾功能衰竭和影响其预后的主要因素 ,控制高危因素 ,防止轻中度肾功能损害向严重肾功能衰竭发展 ,是提高治愈率的关键。一旦发生急性肾功能衰竭 ,宜早期透析治疗。 Objective To analyze the factors leading to renal function damage after cardiac surgery with cardiopulmonary bypass(CPB) and to discuss the approaches of prevention and treatment. Methods 31 patients with renal functional lesion after open heart surgery under cardiopulmonary bypass were divided into two groups basing on prognosis : I,dead 24 cases and Ⅱ,cured 7 cases. Results Renal dysfunction occurred after operation with different degree in the two groups, the duration and severity of low cardiac output in the dead group was significantly higher than that of the cured group (P<0.05). Conclusion Low cardiac output may be the most important factor leading to acute renal failure (ARF) and affecting the prognosis. To reduce the morbidity and mortality of ARF after CPB, great attention needs to be paid on controlling the risk factors and preventing the development of mild or moderate renal dysfunction. Dialysis should be performed in the early stage of ARF.