手术后毛细血管渗漏综合征伴急性肾损伤的临床分析  

Clinical Analysis of Post-operative Capillary Leak Syndrome with Acut Kidney Injury

作　　者：梁伟[1] 石明[1] 程辉[1] 赖小希[1] 王瑞[1] 丁国华[1] 

机构地区：[1]武汉大学人民医院肾内科,430060

出　　处：《医学研究杂志》2013年第3期31-34,共4页Journal of Medical Research

基　　金：国家自然科学基金资助项目(81100478)

摘　　要：目的探讨手术后毛细血管渗漏综合征(CLS)并急性肾损伤的临床特点及治疗方法。方法 6例外科手术后CLS合并急性肾损伤患者,采用液体复苏、糖皮质激素和连续性静脉-静脉血液滤过(CVVH)治疗。结果术后血浆白蛋白浓度20.32±1.35g/L较术前34.68±3.80g/L显著降低(P<0.05);术后血肌酐206.90±120.60μmol/L较术前90.02±24.85μmol/L显著升高(P<0.05)。治疗后4例患者肾功能和血浆白蛋白恢复正常;1例发展为慢性肾衰竭;1例死于多器官功能衰竭。结论外科手术后不明原因白蛋白降低需警惕CLS发生,早期血液净化和胶体复苏治疗可提高救治成功率。Objective To explore the clinical features and management in patients with post -operative capillary leak syndrome （CLS） complicating acute kidney injury. Methods Clinical data of 6 patients with post - operative CLS complicating acute kidney injury was analyzed. Results Postoperative serum albumin concentration was significantly lower than preoperative value （20.32 ~ 1.35g/L vs 34.68 ~ 3.80g/L, P 〈 0.05 ）. Postoperative concentration of serum creatinine was significantly higher than preoperative data （206.90 ＋ 120. 601xmol/L vs 90.02 ~ 24.85p^mol/L, P 〈 0.05 ）. After an intensive therapy with fluid resuscitation, glueoeorticoid and continuous veno - venous hemofihration （CVVH） , 4 patients recovered in renal function and serum albumin, 1 ease developed chronic renal failure and 1 case died of multiple organ failure. Conclusion CLS may be responsible for the post - operative decrease of serum albumin and early blood purification and colloid resuscitation may improve the prognosis of the condition.

关 键 词：毛细血管渗漏综合征 急性肾损伤 连续性静脉-静脉血液滤过 

分 类 号：R654.1[医药卫生—外科学]