中国医药
中國醫藥
중국의약
CHINA MEDICINE
2015年
6期
797-800
,共4页
高绪霞%姚鑫宝%马立萍%王以新
高緒霞%姚鑫寶%馬立萍%王以新
고서하%요흠보%마립평%왕이신
急性肾损伤%心脏外科手术%多巴胺%肌酐
急性腎損傷%心髒外科手術%多巴胺%肌酐
급성신손상%심장외과수술%다파알%기항
Acute kidney injury%Cardiac surgery%Dopamine%Creatinine
目的 研究多巴胺对术前肌酐增高患者心脏外科手术急性肾损伤(AKI)的预防作用.方法 回顾性分析首都医科大学附属北京安贞医院2008年3-10月124例术前肌酐增高的心脏外科手术患者,按照术中是否应用多巴胺将患者分为多巴胺组(106例)和对照组(18例),比较2组患者术后急性肾损伤发生率及重症监护病房(ICU)住院时间差异.结果 多巴胺组和对照组术前一般情况如性别、年龄、体重指数、合并症、心功能Ⅲ～Ⅳ级、血清肌酐水平及评估的肾小球滤过率(eGFR)差异无统计学意义(P＞0.05),术中情况如手术方式、麻醉方式、手术持续时间、术中出血量、术中输液量、输血量及尿量差异无统计学意义(P＞0.05).2组术前血管紧张素转换酶抑制剂、血管紧张素Ⅱ受体拮抗剂等降压药物及他汀类降脂药物的应用差异无统计学意义(P＞0.05).多巴胺组AKI发生率明显低于对照组[38.7％ (41/106)比66.7％ (12/18),P＜0.05],多巴胺组患者在重症监护病房(ICU)住院时间明显短于对照组,差异有统计学意义[(33±4)h比(74±45)h,P＜0.05].结论 术中静脉应用多巴胺可降低术前肌酐增高患者术后AKI发生率,缩短患者ICU住院时间.
目的 研究多巴胺對術前肌酐增高患者心髒外科手術急性腎損傷(AKI)的預防作用.方法 迴顧性分析首都醫科大學附屬北京安貞醫院2008年3-10月124例術前肌酐增高的心髒外科手術患者,按照術中是否應用多巴胺將患者分為多巴胺組(106例)和對照組(18例),比較2組患者術後急性腎損傷髮生率及重癥鑑護病房(ICU)住院時間差異.結果 多巴胺組和對照組術前一般情況如性彆、年齡、體重指數、閤併癥、心功能Ⅲ～Ⅳ級、血清肌酐水平及評估的腎小毬濾過率(eGFR)差異無統計學意義(P＞0.05),術中情況如手術方式、痳醉方式、手術持續時間、術中齣血量、術中輸液量、輸血量及尿量差異無統計學意義(P＞0.05).2組術前血管緊張素轉換酶抑製劑、血管緊張素Ⅱ受體拮抗劑等降壓藥物及他汀類降脂藥物的應用差異無統計學意義(P＞0.05).多巴胺組AKI髮生率明顯低于對照組[38.7％ (41/106)比66.7％ (12/18),P＜0.05],多巴胺組患者在重癥鑑護病房(ICU)住院時間明顯短于對照組,差異有統計學意義[(33±4)h比(74±45)h,P＜0.05].結論 術中靜脈應用多巴胺可降低術前肌酐增高患者術後AKI髮生率,縮短患者ICU住院時間.
목적 연구다파알대술전기항증고환자심장외과수술급성신손상(AKI)적예방작용.방법 회고성분석수도의과대학부속북경안정의원2008년3-10월124례술전기항증고적심장외과수술환자,안조술중시부응용다파알장환자분위다파알조(106례)화대조조(18례),비교2조환자술후급성신손상발생솔급중증감호병방(ICU)주원시간차이.결과 다파알조화대조조술전일반정황여성별、년령、체중지수、합병증、심공능Ⅲ～Ⅳ급、혈청기항수평급평고적신소구려과솔(eGFR)차이무통계학의의(P＞0.05),술중정황여수술방식、마취방식、수술지속시간、술중출혈량、술중수액량、수혈량급뇨량차이무통계학의의(P＞0.05).2조술전혈관긴장소전환매억제제、혈관긴장소Ⅱ수체길항제등강압약물급타정류강지약물적응용차이무통계학의의(P＞0.05).다파알조AKI발생솔명현저우대조조[38.7％ (41/106)비66.7％ (12/18),P＜0.05],다파알조환자재중증감호병방(ICU)주원시간명현단우대조조,차이유통계학의의[(33±4)h비(74±45)h,P＜0.05].결론 술중정맥응용다파알가강저술전기항증고환자술후AKI발생솔,축단환자ICU주원시간.
Objective To investigate the effects of dopamine in preventing postoperative acute kidney injury (AKI) after cardiac surgery in patients with elevated baseline serum creatinine (Scr).Methods Totally 124 patients with elevated baseline Scr who underwent cardiac surgery from March to October 2008 were retrospectively analyzed.The patients were divided into dopamine group (106 cases) and control group (18 cases) according to whether dopamine was administered or not during and after operation.The incidence of postoperative AKI and the length of stay in intensive care unit (ICU) were compared between the two groups.Results There were no significant differences in preoperative data such as gender,age,body mass index,complications,cardiac function,Scr and estimated glomerular filtration rate between the two groups (P ＞ 0.05);intraoperative data such as surgery method,anesthesia method,length of the operation time,volume of blood loss,infusion,blood transfusion and urinary (P ＞ 0.05) showed no significant differences.The application of preoperative medication including angiotensin-converting enzyme inhibitor,angiotensin Ⅱ receptor antagonist and statins had no significant differences (P ＞ 0.05).Compared with that in control group,incidence of AKI decreased significantly in dopamine group [38.7％ (41/106) vs 66.7％ (12/18),P ＜0.05],and the length of stay in ICU was also shortened obviously in dopamine group [(33 ± 4) h vs (74 ± 45) h,P ＜ 0.05].Conclusion In patients with elevated baseline Scr,intraoperative and postoperative intravenous dopamine administration can reduce the incidence of postoperative AKI and shortens the length of stay in ICU after cardiac surgery.
