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奥曲肽对原位肝移植术中尿量及术后早期肾功能的影响;一项随机、双盲、安慰剂对照试验。

The effect of octreotide on urine output during orthotopic liver transplantation and early postoperative renal function; a randomized, double-blind, placebo-controlled trial.

作者信息

Sahmeddini Mohammad Ali, Amini Afshin, Naderi Nima

机构信息

Shiraz Anesthesiology and Intensive Care Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran.

出版信息

Hepat Mon. 2013 Sep 18;13(9):e12787. doi: 10.5812/hepatmon.12787. eCollection 2013.

Abstract

BACKGROUND

Maintenance of the adequate intraoperative renal perfusion is very important during Orthotopic Liver Transplantation (OLT) to prevent acute renal failure.

OBJECTIVES

For the first time, this study was designed to survey the effects of octreotide on urine output during anesthesia for OLT and early postoperative renal function.

PATIENTS AND METHODS

In this randomized double-blind placebo controlled clinical trial, 79 of 89 patients who underwent OLT and fulfilled the study requirement were randomly allocated into two groups. In the octreotide group, the patients received octreotide infusion from the start of the operation. On the other hand, the control group patients received physiologic saline infusion instead of octreotide. The Mean Arterial Pressure (MAP), heart rate, urine output, norepinephrine usage, and dosage during the three stages of OLT, and baseline and postoperative creatinine were recorded and compared between the two groups.

RESULTS

No significant differences were found between the two groups regarding the demographic characteristics and graft factors (P > 0.05). However, urine output and MAP during the three stages of OLT were significantly higher in the octreotide group compared to the control group (P < 0.05). Moreover, no significant difference was observed between the two groups regarding baseline as well as postoperative creatinine (P > 0.05).

CONCLUSIONS

The results demonstrated that octreotide infusion during anesthesia for OLT not only augmented the vasoconstriction effect of norepinephrine to increase MAP, but also maintained better renal perfusion and urine output during the operation.

摘要

背景

在原位肝移植(OLT)过程中维持足够的术中肾灌注对于预防急性肾衰竭非常重要。

目的

本研究首次旨在调查奥曲肽对OLT麻醉期间尿量及术后早期肾功能的影响。

患者与方法

在这项随机双盲安慰剂对照临床试验中,89例接受OLT且符合研究要求的患者中有79例被随机分为两组。奥曲肽组患者从手术开始即接受奥曲肽输注。另一方面,对照组患者接受生理盐水输注而非奥曲肽。记录并比较两组在OLT三个阶段的平均动脉压(MAP)、心率、尿量、去甲肾上腺素使用情况及剂量,以及基线和术后肌酐水平。

结果

两组在人口统计学特征和移植物因素方面无显著差异(P>0.05)。然而,与对照组相比,奥曲肽组在OLT三个阶段的尿量和MAP显著更高(P<0.05)。此外,两组在基线及术后肌酐水平方面未观察到显著差异(P>0.05)。

结论

结果表明,OLT麻醉期间输注奥曲肽不仅增强了去甲肾上腺素的血管收缩作用以提高MAP,还在手术期间维持了更好的肾灌注和尿量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce64/3830523/ee377550bc9d/hepatmon-13-09-12787-i001.jpg

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