远隔缺血预处理在急性主动脉夹层手术中的肾脏保护作用  

Renal Protection of remote ischemic Preconditioning in acute aortic Dissection Surgery

作　　者：蒋伟[1] 刘建华[1] 石光 梁巧如[1] 闫小清[1] JIANG Wei;LIU Jianhua;SHI Guang;LIANG Qiaoru;YAN Xiaoqing(Extracorporeal Circulation Department,Chest Pain Center,Henan Provincial Chest Hospital,Zhengzhou Henan 450000,China)

机构地区：[1]河南省胸科医院胸痛中心体外循环科,河南郑州450000

出　　处：《临床研究》2021年第3期1-3,共3页Clinical Research

基　　金：2018年河南省医学科技攻关计划项目(2018020569)。

摘　　要：目的本研究旨在探讨远隔缺血预处理对急性主动脉夹层患者的肾脏保护作用。方法选择80例于2017年4月至2018年4月在河南省胸科医院胸痛中心行主动脉夹层手术的患者,应用随机数字表法分为两组,每组40例,其中实验组在术前应用远隔缺血预处理技术,对照组将压力阻断带置于左侧下肢,不予充气。分别检测两组患者术前、术后12 h、术后24 h和术后48 h血肌酐、血尿素氮浓度,并分别计算两组患者各相应时间点的内生肌酐清除率,评价是否发生急性肾损伤。结果两组患者的一般资料相比差异无统计学意义(P>0.05)。实验组患者术后48 h血肌酐浓度明显低于对照组,差异有统计学意义(P<0.05);实验组患者术后48 h内生肌酐清除率低于对照组,差异有统计学意义(P<0.05)结论远隔缺血预处理有助于急性主动脉夹层患者的肾功能保护。Objective To investigate the renal protective effect of remote ischemic preconditioning in patients with acute aortic dissection.Methods A total of 80 patients who underwent thoracic surgery in the chest pain center of Henan provincial chest hospital from April 2017 to April 2018 were randomLy divided into two groups,40 patients in each group,the experimental group was treated with remote ischemic preconditioning technique before operation,while the control group was placed the pressure block band on the left lower limb without inflating.The serum creatinine(CR)and blood urea nitrogen were measured before operation,12 h after operation,24 h after operation and 48 h after operation,and the endogenous creatinine(CR)clearance rates were calculated to evaluate whether acute renal injury occurred.Results There was no significant difference in the general data between the two groups(P>0.05).The serum creatinine concentration in the experimental group was significantly lower than that in the control group at 48 hours postoperatively(P<0.05),and the creatinine clearance rate in the experimental group was lower than that in the control group at 48 hours postoperatively,the difference was statistically significant(P<0.05).Conclusion Remote ischemic preconditioning is helpful to protect renal function in patients with acute aortic dissection.

关 键 词：远隔缺血预处理 急性主动脉夹层 肾功能 

分 类 号：R654.2[医药卫生—外科学]