体外循环心脏直视术后肾上腺皮质功能不全的诊治进展  

Adrenal insufficiency after cardiovascular surgery with cardiopulmonary bypass

作　　者：张煜 胡佳[2] 杨鹏[2] 卢晨 黄尧 张洪伟[2] ZHANG Yu;HU Jia;YANG Peng;LU Chen;HUANG Yao;ZHANG Hongwei(West China School of Medicine,Sichuan University,Chengdu,610041,P.R.China;Department of Cardiovascular Surgery,West China Hospital,Sichuan University,Chengdu,610041,P.R.China)

机构地区：[1]四川大学华西临床医学院,成都610041 [2]四川大学华西医院心脏大血管外科,成都610041

出　　处：《中国胸心血管外科临床杂志》2020年第1期85-89,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：国家自然科学基金(81670327,81300155);四川省科技计划项目(2019YJ0046)

摘　　要：肾上腺皮质功能相对或绝对不全在体外循环心脏直视手术后较为常见,但由于其症状隐匿,并未引起心脏外科及重症监护医师的足够重视。然而,围术期肾上腺皮质相关激素水平不足会严重影响术后血流动力学稳定,显著增加围术期心血管不良事件发生的风险。现阶段,对于心血管外科患者体外循环术后出现围术期肾上腺皮质功能不全的关注和系统研究鲜有报道。因此本文就此类病症的病因、危险因素、潜在发病机制和相关研究进展作简要综述。Relative/absolute adrenal insufficiency is not uncommmon in the patients undergoing cardiovascular surgery with cardiopulmonary bypass.However,this complication was rarely reported due to its unspecific clinical presentations and the unawareness of ICU physicians and cardiac surgeons.However,this puts them on a higher risk of hemodynamic instability and cardiovascular adverse events during hospitalization.Systematic reviews concentrated on it are rarely reported currently.We aim to review the etiology,risk factors,potential pathogenesis and related research progress for this complication.

关 键 词：体外循环心脏直视手术 肾上腺皮质功能不全 肾上腺危象 

分 类 号：R654.2[医药卫生—外科学] R586[医药卫生—临床医学]