老年患者腹壁巨大切口疝术后肾功能的变化  

Changes of Postoperative Renal Function in the Elderly after Giant Abdominal Incisional Hernia Surgery

作　　者：俞瑞东[1] 吴志雄[1] 韩冰[1] 陆小川[1] 金凯[1] 宋晓华[1] Yu Ruidong;Wu Zhixiong;Han Bing;Lu Xiaochuan;Jin Kai;Song Xiaohua(Intensive Care Unit, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, P. R. Chin)

机构地区：[1]复旦大学附属华东医院重症监护室,上海200040

出　　处：《老年医学与保健》2018年第2期195-197,202,共4页Geriatrics & Health Care

基　　金：上海市卫生计生系统重要薄弱学科建设-老年医学(2015ZB501)

摘　　要：目的探讨老年患者腹壁巨大切口疝无张力修补术后肾功能的变化。方法监测71例巨大切口疝术前及无张力修补术后当天~第5天的肾功能指标的变化以及血利尿钠肽(BNP)的变化。结果患者术后第1、第2天的血肌酐(Scr)较术前升高,差异有统计学意义(P<0.05);术后第2~第4天血尿素氮(BUN)较术前升高,差异有统计学意义(P<0.05);术后第1~第5天BNP较术前均升高,差异有统计学意义(P<0.05),但肾功能的损伤与BNP的升高无相关性。结论巨大切口疝无张力修补术后可导致肾功能及心功能的损伤,但两者无相关性,肾功能的损伤是否与腹腔压力有关需进一步研究。Objective To investigate the changes of renal function after tension-free hernioplasty of abdominal giant incisional hernia in the elderly. Methods The changes in renal function index and the changes of brain natriuretic peptide （BNP） in 71 elderly patients with abdominal giant incisional hernia during the period from the day of tension-free hernioplasty to the 5th day after surgery were monitored and recorded. Results The levels of Scr on the first and second day after surgery were higher than that before surgery, the difference was of statistical significance （P 〈 0.05）;. the level of BUN from the second day to the 4th day after surgery was statistical higher than that before surgery （P〈0.05）; the level of BNP from the first day to the 5th day after surgery was higher than that before surgery with statistical difference （P〈0.05） while there existed no correlation between renal function impairment and the increase of BNP. Conclusions The tension-free hernioplasty of giant abodominal incisional hernia may lead to the impairment of renal function and cardiac function, but there is no correlation between them; further study is needed to explore the possible association between renal function impairment and abdominal pressure.

关 键 词：老年 切口疝 腹腔压力 肾功能 

分 类 号：R656[医药卫生—外科学]