CAJ | 학술논문

背景:全膝关节表面置换中植入假体系统、围手术期血流动力学的改变、药物等均可能对患者肾功能产生影响. 目的:动态观察膝关节表面置换术围手术期相关处理对患者肾功能的影响. 方法:纳入膝关节表面置换患者42例,检测患者置换前后血清肌酐、胱抑素C及尿微量白蛋白水平,比较置换前后患者肾功能. 结果与结论:42例患者全膝关节表面置换均成功,在置换后1个月内未发生少尿、无尿、大量蛋白尿、肾衰竭等严重的肾脏并发症.围手术期血清肌酐水平未发生明显变化;胱抑素C水平在置换后1周内无明显变化,而在置换后1个月,较置换前下降;尿微量白蛋白水平在置换后1 d上升,自置换后3 d开始呈下降趋势,置换后7 d、1个月尿微量白蛋白水平均较置换前降低.结果说明,全膝关节表面置换对患者肾功能仅产生了轻度的一过性损伤,并且置换后1个月患者肾功能平均水平得到改善.对初次行单侧膝关节表面置换患者,围手术期积极恰当的临床处理,不致对肾功能产生严重损伤.
배경:전슬관절표면치환중식입가체계통、위수술기혈류동역학적개변、약물등균가능대환자신공능산생영향. 목적:동태관찰슬관절표면치환술위수술기상관처리대환자신공능적영향. 방법:납입슬관절표면치환환자42례,검측환자치환전후혈청기항、광억소C급뇨미량백단백수평,비교치환전후환자신공능. 결과여결론:42례환자전슬관절표면치환균성공,재치환후1개월내미발생소뇨、무뇨、대량단백뇨、신쇠갈등엄중적신장병발증.위수술기혈청기항수평미발생명현변화;광억소C수평재치환후1주내무명현변화,이재치환후1개월,교치환전하강;뇨미량백단백수평재치환후1 d상승,자치환후3 d개시정하강추세,치환후7 d、1개월뇨미량백단백수평균교치환전강저.결과설명,전슬관절표면치환대환자신공능부산생료경도적일과성손상,병차치환후1개월환자신공능평균수평득도개선.대초차행단측슬관절표면치환환자,위수술기적겁흡당적림상처리,불치대신공능산생엄중손상.
@@@@BACKGROUND:Implanting prosthesis system during operation, perioperative haemodynamics changes and drugs may affect the renal function of patients receiving total knee arthroplasty. @@@@OBJECTIVE:To dynamical y assess the effect of relative treatment on the renal function in the perioperative period of total knee arthroplasty. @@@@METHODS:Forty-two patients with total knee arthroplasty were included. The serum creatinine, cystatin C and microalbuminuria levels before and after total knee arthroplasty were detected, and then renal function before and after replacement were compared. @@@@RESULTS AND CONCLUSION:Al of the total knee arthroplasty operations were successful in 42 patients, and no oliguria, anuria, amount urinary protein and renal failure or other serious kidney complications were observed within 1 month after total knee arthroplasty. There was no change in serum creatinine level, so was cystatin C in 1 week after total knee arthroplasty, but the cystatin C level was decreased significantly at 1 month after the operation. The microalbuminuria concentration was increased at 1 day after total knee arthroplasty, and began to descent on day 3, and the microalbuminuria concentration at 7 days and 1 month after total knee arthroplasty was decreased when compared with that before operation. Total knee arthroplasty only caused mild damage to patients’ renal function, while the average level of renal function was improved at 1 month later. To the patients who receive the unilateral total knee arthroplasty for the first time, active appropriate clinical treatment may al eviate the kidney damage.