术中容量治疗对移植肾早期功能的影响  

The effect of volume resuscitation in opration on the early function of grafted kidney

作　　者：陈益群[1] 康健[1] 赖西铭[1] 

机构地区：[1]东莞市太平人民医院麻醉科,广东省东莞523900

出　　处：《中国基层医药》2006年第6期975-976,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨肾移植术中容量负荷对移植肾早期功能的影响。方法909例接受同种异体肾移植术患者,根据术中容量治疗量(ml/kg)分为A组:<20;B组:20～29;C组:30～39;D组:40～49;E组:≥50。对比观察移植肾功能延迟恢复(DGF)和急性肾小管坏死(ATN)发生率。结果DGF的发生率,A组54.2%,高于B组的31.5%(P<0.05);ATN的发生率,A组(13.8%)高于其他组(B组6.5%,C组6.4%,D组5.9%,E组8.7%),差异有统计学意义(P<0.01)。但A组在年龄、体重、MAP和CVP术前基础值高(P<0.05)。结论肾移植术中液体治疗要结合MAP和CVP的动态变化调整。Objective To observe the effect of volume resuscitation on the early grafted kidney function in opration. Methods 909 cases were divided into five groups according to the volume resuscitation in opration：group A： 〈 20ml/kg（ n = 91 ） ; B： 20 - 29ml/kg（ n = 247 ） ; C ： 30 - 39ml/kg （ n = 280 ） ; D： 40 - 49ml/kg （ n = 179 ） ; E ：≥50ml/kg（ n = 112）. The ratio of ereatine in the first day posttransplant and creatine before operation was ≥75 %, the graft kiney was named the delayed graft function（DGF）. The ratio of DGF and the ratio of ATN were observed. Results The ratio of DGF group（A～E） was：54.2% ,31.5% ,51.4% ,32.6% ,38.3%. The ratio of ATN group （A～E） was： 13.8 %, 6.5 %, 6.4 %, 5.9 %, 8.7 %. The ratio of DGF was significantly higher in group A than in group B（ P 〈 0.05 ）. The ratio of ANT was significantly higher in group A than in the other groups（ P 〈 0.01 ） ; But age and weight and MAP and CVP were significantly higher in group A on preoperation than in the other groups（ P 〈0. 05 ）. Conclusion ： Volume resuscitation of kidney transplantation patients in operation is adjusted according to the relationship of MAP and CVP.

关 键 词：肾移植 容量治疗 肾功能 

分 类 号：R699[医药卫生—泌尿科学]