术中脑氧饱和度监测对心脏手术患者术后急性肾损伤的影响  

Effect of intraoperative monitoring of cerebral oxygen saturation on postoperative acute kidney injury in patients undergoing cardiac surgery

作　　者：马志伟 颜文[1] 路畅[1] 潘晨宇[1] MA Zhiwei;YAN Wen;LU Chang;PAN Chenyu(Department of Anesthesiology,the Second Hospital of Jilin University,Changchun 130041,China)

机构地区：[1]吉林大学第二医院麻醉科,长春130041

出　　处：《长春中医药大学学报》2024年第11期1256-1259,共4页Journal of Changchun University of Chinese Medicine

基　　金：吉林省教育厅“十三五”科学技术项目(JJKH20211180KJ)。

摘　　要：目的评估术中脑氧饱和度监测对心脏手术患者术后急性肾损伤的影响。方法本研究回顾性分析了吉林大学第二医院2018年6月-8月术前肾功能正常在体外循环下行心脏瓣膜置换术患者40例。根据术后急性肾损伤诊断标准,将患者分为急性肾损伤组(11例)和非急性肾损伤组(29例)。回顾性收集所有患者的人口统计学资料,记录患者入室时(T0)、夹闭升主动脉时(T1)、夹闭升主动脉后30 min(T2)、开放升主动脉(T3)及手术结束时(T4)双侧脑氧饱和度数值。收集患者ICU停留时间、住院时间、肾替代治疗的例数以及30 d死亡率。结果急性肾损伤组术中脑氧饱和度值比非急性肾损伤组偏低,ICU停留及住院时间延长。结论术中应用脑氧饱和度监测并维持相对较高值,能够减少术后急性肾损伤的发生。Objective To evaluate the effect of intraoperative monitoring of cerebral oxygen saturation on postoperative acute kidney injury in patients undergoing cardiac surgery.Methods This study retrospectively analyzed 40 patients with normal preoperative renal function who underwent cardiac valve replacement under cardiopulmonary bypass in the Second Hospital of Jilin University from June to August 2018.According to the diagnostic criteria of postoperative acute renal injury,the patients were divided into the acute kidney injury group(n=11)and the non-acute kidney injury group(n=29).The demographic data of all patients were collected retrospectively,and bilateral cerebral oxygen saturation values at the time of entering(T0),clipping of ascending aorta(T1),30 minutes after clipping of ascending aorta(T2),opening of ascending aorta(T3)and at the end of surgery(T4)were recorded.ICU stay time,hospitalization time,the number of patients of renal replacement therapy,and the 30 day mortality of patients were collected.Results The value of intraoperative cerebral oxygen saturation in the acute kidney injury group was lower than that in non-acute kidney injury group,and ICU stay time and hospitalization time were prolonged.Conclusion During operation,the application of monitoring of cerebral oxygen saturation and maintaining it at the relatively high value can reduce the occurrence of acute renal injury after surgery.

关 键 词：脑氧饱和度 心脏手术 急性肾损伤 

分 类 号：R654.2[医药卫生—外科学]