单侧肾切除术对患者术后血压的影响  

Effect of unilateral nephrectomy on postoperative blood pressure

作　　者：李双利[1] 李守宾[2] 马建锋[3] 于春红[4] 沙泉[3] 邢爱君[5] 李连印[1] 温英武[1] 高双友[1] LI Shuang-li LI Shou-bin MA Jian-feng YU Chun-hong SHA Quan XING Ai-jun LI Lian-yin WEN Ying-wu GAO Shuang-you(Department of Urology Kailuan General Hospital, Tangshan 063000 Department of Urology, Hebei General Hospital, Shijiazhuang 050051 Department of Urology, Baoding No. 1 Hospital, Baoding 071000 Department of Ophtalmology Department of Cardiology, Kailuan General Hospital, Tangshan 063000, China)

机构地区：[1]开滦总医院泌尿外科,唐山063000 [2]河北省人民医院泌尿外科,石家庄050051 [3]保定市第一医院泌尿外科,保定071000 [4]开滦总医院眼科,唐山063000 [5]开滦总医院心内科,唐山063000

出　　处：《现代泌尿外科杂志》2017年第4期271-273,290,共4页Journal of Modern Urology

基　　金：河北省科技厅指令性计划项目(No.14277734D)

摘　　要：目的探讨单侧肾切除术对患者术后血压的影响。方法对2009年6月至2014年6月在我科行单侧肾切除术的患者进行随访,比较术后与术前的血压并进行分析。结果随访了110名患者,随访时间2~7年,术后血压与术前血压比较,收缩压较术前下降(P<0.05),舒张压无明显变化。按术前有无高血压分组分析,高血压组术后收缩压下降明显,非高血压组下降不明显,两组舒张压无明显变化。对影响血压下降的因素进行Logistic分析,发现术前收缩压水平是影响术后收缩压下降幅度的独立危险因素(OR=1.248,P=0.003)。结论单侧肾切除术会导致术前有高血压的患者收缩压下降,术前收缩压越高,术后下降越明显,对舒张压无明显影响,对术前血压正常的患者的血压无明显影响。Objective To investigate the effect of unilateral nephrectomy on postoperative blood pressure （BP）. Methods Patients who underwent unilateral nephrectomy at our institution during 2009 and 2014 were followed up. Perioperative BP data were collected and compared. Results A total of 110 patients were followed up for 2-7 years. The postoperative systolic BP was much lower than the preoperative level （P〈0.05）. However, the postoperative diastolic BP was not signifi- cantly different from preoperative level. In hypertensive patients, postoperative systolic BP significantly decreased, whereas in non-hypertensive patients, it remained unchanged. There was no significant difference between pre- and post-operative dias- tolic BP in patients with/without hypertension. Multivariate logistic regression analysis revealed preoperative systolic BP level was an independent risk factor of decrease amplitude of postoperative systolic BP （OR = 1. 248, P= 0. 003）. Conclusions U- nilateral nephrectomy results in systolic rather than diastolic BP decrease in patients with hypertension, and preoperative systolic BP level is positively correlated with decrease amplitude of postoperative systolic BP. However, unilateral nephrectomy has no significant effect on BP of patients with normal preoperative BP.

关 键 词：高血压 肾切除术 肾细胞癌 

分 类 号：R544.1[医药卫生—心血管疾病]