天津医药

天津医药 ›› 2017, Vol. 45 ›› Issue (1): 51-53.doi: 10.11958/20160535

• 临床研究 • 上一篇    下一篇

心脏移植术后急性肾功能损伤的临床观察

薛奋龙， 柴军武， 陈洪磊， 周巍， 王凯， 孔祥荣   

  1. 天津市第一中心医院心血管外科 （邮编 300192）
  • 收稿日期:2016-06-12 修回日期:2016-11-28 出版日期:2017-01-15 发布日期:2017-01-15
  • 通讯作者: 孔祥荣 E-mail:120977098@qq.com

Clinical observation of acute kidney injury in patients after heart transplantation

XUE Fen-long, CHAI Jun-wu, CHEN Hong-lei, ZHOU Wei, WANG Kai△, KONG Xiang-rong   

  1. Department of Cardiac Surgery, Tianjin First Central Hospital, Tianjin 300192, China
  • Received:2016-06-12 Revised:2016-11-28 Published:2017-01-15 Online:2017-01-15

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摘要： 摘要： 目的 总结心脏手术后急性肾损伤 （CAS-AKI） 的治疗经验。方法 回顾性分析我院 2009 年 1 月—2016 年 7 月收治的 9 例原位心脏移植术后发生 AKI 的患者临床资料， 其中 3 例应用大剂量利尿剂（呋塞米>80 mg/d）治 疗， 6 例行连续性肾脏替代治疗 （CRRT）。比较心脏移植术前、 术后及 AKI 治疗后患者血肌酐 （Cr） 及估测肾小球滤过 率（eGFR）变化， 观察患者围术期的生存质量。结果 经过利尿剂或 CRRT 治疗后， 患者总体血 Cr 水平下降， eGFR 水平升高， 肾功能有所恢复。经利尿剂治疗的患者 eGFR 恢复效果优于 CRRT 者。结论 CSA-AKI 发生后应根据 患者的严重程度采取综合治疗， 减轻肾功能损伤。

关键词: 心脏移植, 手术期间, 肾功能衰竭, 急性, 围术期, 利尿药, 肾小球滤过率, 持续血液滤过, 肌酐

Abstract: Abstract: Objective To summarize the treatment experiences in patients with cardiac surgery- associated acute kidney injury (CSA- AKI). Methods The clinical data of 9 patients with acute renal injury after orthotopic heart transplantation in our hospital from January 2009 to July 2016 were retrospectively analyzed. Three patients were required the high- dose diuretics (furosemide, >80 mg/d) and six patients were received continuous renal replacement therapy (CRRT). The levels of serum creatinine (Cr) and estimated glomerular filtration rate (eGFR) were compared before and after heart transplantation and after the treatment of AKI. The quality of life was observed in patients in perioperative period. Results After the treatment of diuretics or CRRT, patients showed renal function recovery with significant decreased Cr levels and increased eGFR compared with the postoperation. The patients with diuretic therapy revealed a better eGFR recovery than those with CRRT. Conclusion CSA- AKI should be based on the severity of disease, and comprehensive treatment should be taken to reduce renal damage.

Key words: heart transplantation, intraoperative period, kidney failure, acute, perioperative period, diuretics, glomerular filtration rate, continuous renal replacement therapy, creatinine

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