心脏死亡供体肾功能的保护  

The protection of renal function for cardiac death donor

作　　者：韦中余[1] 韩永仕 

机构地区：[1]武警总医院器官移植研究所,北京100039

出　　处：《实用器官移植电子杂志》2016年第5期282-285,共4页Practical Journal of Organ Transplantation(Electronic Version)

摘　　要：目的探讨心脏死亡供体的肾功能保护。方法回顾性分析了武警总医院2013年9月—2016年6月完成的268例可控型心脏死亡器官捐献（DCD）供体的临床资料,对其个体化治疗进行总结分析。结果在268例供体中入科时少尿者46例,血浆白蛋白偏低者134例,经过积极补液扩容,补充白蛋白纠正低蛋白血症,使中心静脉压（CVP）维持在8~12mm Hg（1mm Hg=0.133k Pa）,其中有15例在术前尿量较前增多,总有效率达32.6%。85例使用升压药者中有47例去甲肾上腺素的用量也较前有所减少,在15例入科时肌酐高的患者中有11例出现肌酐下降,有效率为73%。结论在监测CVP的情况下积极进行补液扩容有利于供肾的器官功能保护。Objective To investigate the protection of renal function for cardiac death donor. Methods The clinical data of 268 patients with controllable cardiac death organ donation（DCD） from the Armed Police General Hospital between September 2013 and June 2016 were analyzed retrospectively and the individual treatment was summarized and analyzed. Results In 268 donors, 46 patients with oliguria and 134 patients with low plasma albumin. These patients have been positive treated with rehydration and albumin for expanding blood volume and correction of hypoproteinemia and maintain central venous pressure（CVP） at 8-12 mm Hg（1 mm Hg = 0.133 k Pa）. The urine output increased before surgery compared with the previous by treatment in 15 patients,total effective rate was 32.6%. In 85 patients who were using the vasopressor, the dosage of norepinephrine was decreased,and the serum creatinine levels was decreased in 11 of the 15 patients with high creatinine at admission, the effective rate was 73%. Conclusion In the case of monitoring CVP, the positive fluid infusion volume is beneficial to the protection of renal function.

关 键 词：心脏死亡 供体 肾功能保护 

分 类 号：R699.2[医药卫生—泌尿科学]