肾氧饱和度监测临床应用的最新研究进展  

Progress in clinical application of renal oxygen saturation monitoring

作　　者：李雪[1] 邱林 赵亮[1] 徐红党 郎志斌 张加强 林洪启 LI Xue;QIU Lin;ZHAO Liang;XU Hong-dang;LANG Zhi-bin;ZHANG Jian-qiang;LIN Hong-qi(Department of Anesthesiology,Henan University People's Hospital,Henan Provincial People's Hospital,Central China Fuwai Hospital,Zhengzhou,Henan,450003,China)

机构地区：[1]河南大学人民医院河南省人民医院麻醉与围术期医学科华中阜外医院麻醉科,郑州450003

出　　处：《医药论坛杂志》2020年第3期166-169,共4页Journal of Medical Forum

基　　金：河南省医学科技攻关计划省部共建项目(SB201901098);河南省医学科技攻关计划项目(2018020460)。

摘　　要：急性肾损伤(AKI)是心血管手术围术期一种严重的并发症,也是围术期死亡的重要危险因素之一。目前急性肾损伤的主要诊断指标是血清肌酐(Scr)和尿量,但在肾功能丧失50%之前,Scr和尿量一般无明显的变化。对于急性肾损伤的诊断,缺乏早期监测肾脏组织灌注的指标。近红外光谱监测仪(NIRS)是一种新型无创监测局部组织氧供需平衡的仪器。目前主要用于监测脑组织灌注,大量研究表明脑氧饱和度在围术期的应用,减少了患者术后认知功能障碍等神经系统相关并发症的发生,缩短患者的拔管时间、ICU停留时间,改善患者预后。目前对于近红外光谱技术监测肾脏组织在临床的应用较少。本文拟对肾氧饱和度监测在临床的相关研究和应用作一综述,为围术期肾功能保护提供一些临床参考,以减少临床急性肾损伤的发生,改善患者的预后。Objective Cute renal injury(AKI)is a serious complication in the perioperative period of cardiovascular surgery,and it is also one of the important risk factors of perioperative death.At present,the main diagnostic indexes of acute renal injury are serum creatinine(Scr)and urine volume,but before the loss of renal function by 50%,there is no significant change in Scr and urine volume.For the diagnosis of acute renal injury,there is a lack of early monitoring of renal tissue perfusion.Near infrared spectroscopy(NIRS)is a new non-invasive instrument for monitoring the balance of oxygen supply and demand in local tissues.At present,it is mainly used to monitor cerebral tissue perfusion.A large number of studies show that the application of cerebral oxygen saturation in perioperative period can reduce the occurrence of neurological complications such as postoperative cognitive dysfunction,shorten the extubation time and ICU stay time of patients,and improve the prognosis of patients.At present,there is little clinical application of near infrared spectroscopy in monitoring renal tissue.This paper reviews the clinical research and application of renal oxygen saturation monitoring in order to provide some clinical reference for perioperative renal function protection,reduce the incidence of clinical acute renal injury and improve the prognosis of patients.

关 键 词：肾氧饱和度 临床应用 进展 

分 类 号：R692.5[医药卫生—泌尿科学]