Bukowski J G, Houet J F, Lepoitevin L, Chapillon M, Delhumeau A
Département d'Anesthésie-Réanimation, CHRU d'Angers.
Ann Fr Anesth Reanim. 1989;8(6):659-61. doi: 10.1016/s0750-7658(89)80184-4.
A case is reported of acute renal failure occurring after prolonged abdominal aortic bypass surgery in an overweight 69-year-old male patient. Preoperative serum creatinine concentration was normal. Surgery lasted for 6 h, and infrarenal aortic cross-clamping 2 1/2 h. The patient complained of important lumbar pain immediately after the operation. In the same time, oliguria and acute renal failure also developed (creatinine: 464 mumol.l-1; urea: 13 mmol.l-1). Rhabdomyolysis caused by the kidney-bridge was confirmed by the elevated blood creatine phosphokinase levels (16,000 IU.l-1 on the second postoperative day). A 99 m-Technetium methylene-diphosphonate imaging on the 10th postoperative day exhibited diffuse fixation in the paravertebral lumbar and thoracic muscles, extending from Th8 to L3. The acute renal failure regressed completely after haemodialysis.
报道了一例69岁超重男性患者在长时间腹主动脉搭桥手术后发生急性肾衰竭的病例。术前血清肌酐浓度正常。手术持续了6小时，肾下主动脉阻断2.5小时。患者术后立即主诉严重的腰痛。同时，少尿和急性肾衰竭也出现了（肌酐：464μmol·L⁻¹；尿素：13mmol·L⁻¹）。术后第二天血肌酸磷酸激酶水平升高（16,000IU·L⁻¹）证实了由肾桥引起的横纹肌溶解。术后第10天的99m-锝亚甲基二膦酸盐显像显示椎旁腰段和胸段肌肉弥漫性固定，范围从胸8延伸至腰3。血液透析后急性肾衰竭完全消退。
