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作 者:邹斌[1] 吴起才[1] 万力[1] 凌翔[1] 曾尚干[1] 凌华[1]
机构地区:[1]南昌大学第一附属医院心胸外科,南昌330006
出 处:《南昌大学学报(医学版)》2010年第7期64-66,共3页Journal of Nanchang University:Medical Sciences
摘 要:目的探讨应用离心泵和滚压泵对体外循环(cardiopul monary bypass,CPB)术后肾功能的影响。方法 23例CPB下行双瓣置换术(二尖瓣和主动脉瓣)的患者按随机数字表法分为离心泵组(n=11)和滚压泵组(n=12)。常规建立CPB,行心脏瓣膜置换术。检测术前(T1)、手术结束时(T2)、术后24 h(T3)和术后48 h(T4)血肌酐(Ser-umcreatinine,Scr)、尿N-乙酰-β-氨基葡萄糖苷酶(N-acetyl-β-D-glucosaminidase,β-NAG)及尿α1-微球蛋白(alpha1-microglobulin,α1-MG)的水平。结果 2组患者术后24 h Scr水平明显升高,但均处于正常水平,任何时点组间比较差异无统计学意义(均P>0.05)。2组患者尿α1-MG及β-NAG水平在术后明显升高,以滚压泵组更为显著,T2、T3和T4时点组间比较,差异有统计学意义(P<0.05)。结论研究表明体外循环应用离心泵较滚轴泵明显减轻对肾脏的损伤。Objective To explore the effect of centrifugal pump and roller pump on kidney function after cardiopulmonary bypass(CPB).Methods Twenty-three patients undergoing double valves replacement(mitral valve and aortic valve) were randomly assigned into either centrifugal pump group(n=11) or roller pump group(n=12).Serum creatinine(Scr),urine N-acetyl-β-D-glucosaminidase(β-NAG) and alpha1-microglobulin(α1-MG) were measured after induction of anesthesia,at the end of the operation,and on the first and second postoperative days.Results Scr significantly elevated in the two groups on the first postoperative day but remained normal,with no difference between the two groups during the entire study period(all P0.05).Urine concentrations of β-NAG and α1-MG increased significantly after CPB,with the highest increase in roller pump group,and there were significant differences between the two groups on the three postoperative points(P0.05).Conclusion Kidney injury in patients treated with centrifugal pump is less pronounced than that in patients treated with roller pump.
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