右美托咪定对心脏瓣膜置换术患者围术期肾功能的影响  

Effects of Dexmedetomidine on Renal Function of Patients after Valvular Heart Surgery

作　　者：张政[1] 何江[2] 李莎[1] 何波[3] 蔡珺[1] 

机构地区：[1]中山大学附属第三医院,广州市510630 [2]广东省清远市人民医院,511518 [3]中山大学孙逸仙纪念医院,广州市510120

出　　处：《实用医学杂志》2016年第20期3439-3442,共4页The Journal of Practical Medicine

基　　金：广东省科技计划项目资助项目(编号:2012B050600018;2013B022000050)

摘　　要：目的:探讨右美托咪定对行瓣膜置换患者术后肾功能的影响。方法:50例择期行瓣膜置换术患者,随机分成研究组和对照组,每组25例。研究组诱导前15 min静脉泵注右美托咪定0.5μg/kg,随后以0.5μg/(kg·h)泵注至术毕,对照组采用同样方法静脉泵注等容量生理盐水。于术前、术毕、术后24、48 h抽取中心静脉血测定BUN、Scr和Cys C浓度;记录停留ICU时间。结果:与术前相比,两组患者的Scr和Cys C在术后24 h显著上升,而BUN在术后24、48 h均有显著上升(P<0.05);而与对照组相比,研究组患者术后24 h的Scr、BUN、Cys C浓度显著降低(P<0.05);而且ICU停留时间更短(P<0.05)。结论:右美托咪定能改善瓣膜置换术后肾功能,改善患者预后。Objective To investigate the effect of dexmedetomidine on postoperative renal function of patients with rheumatic heart disease following valvular heart surgery. Methods Fifty patients following valvular heart surgery were randomized into experimental group and control group,with 25 cases in each group. The patients in experimental group receiveddexmedetomidine 0.5 μg / kg infusion 15 min before induction, and then 0.5 μg /（kg·h） infused to the end of surgery, while those in control group received the same amount of saline in the same way. Blood from central venous was collected before surgery, at the end of surgery, 24 h and 48 h after surgery in order to detect Src, BUN and Cys C and the length of ICU duration was also recorded. Results Src and Cys C of the patients in both groups obviously elevated 24 h after surgery when compared with pre-operation,while BUN elevated at both 24 h and 48 h after surgery（P〈0.05）. Compared with those in control group, Src,BUN and Cys C were lower in experimental group（ P〈0. 05）, and the length of ICU duration was shorter（ P〈0.05）. Conclusion Dexmedetomidine could improve the postoperative renal function after valvular heart surgery and lead to a better prognosis.

关 键 词：风湿性心脏病 右美托咪定 心脏瓣膜置换术 肾功能 

分 类 号：R614[医药卫生—麻醉学]