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肾移植中静脉推注与静脉输注呋塞米的比较:一项随机临床试验

Bolus Injection Versus Infusion of Furosemide in Kidney Transplantation: A Randomized Clinical Trial.

作者信息

Zomorrodi Afshar, Mohammadipoor Anvari Hassan, Kakaei Farzad, Solymanzadeh Farzin, Khanlari Esmaeil, Bagheri Amin

机构信息

Department of Urology, Emam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.

Department of Anesthesiology, Emam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.

出版信息

Urol J. 2017 Mar 16;14(2):3013-3017.

Abstract

PURPOSE

Furosemide is commonly administered to increase the urinary output in patients with transplanted kidneys. This study compared the two administration routes of furosemide (bolus versus infusion) in kidney transplanted patients.

MATERIALS AND METHODS

Fifty patients who had undergone kidney transplantation in 2015 in a hospital in Tabriz, Iran, were included in this clinical trial. They were divided into two groups: bolus (120 mg stat) and infusion (4 mg/minute) groups. The primary outcome was urine onset time. Secondary outcomes were urine output volume, vital signs (blood pressure, heart rate), and electrolyte level (creatinine, blood urea nitrogen, sodium and potassium). After arterial and venous anastomoses, arterial clamp removal time and diuresis onset were recorded. Finally, theurinary output volumes of both groups were measured with regular urine bags for an hour after anastomosis. Then it was repeated each three hours for 24 hours, and eventually two and three days thereafter. Finally, all data were statistically analyzed.

RESULTS

Around 72% of the patients were men (mean age of 37.15 ± 14.67 years). Urine output was higher in bolus group but it was not statistically significant. Diuresis duration was measured after arterial declamping and its averages were 5.41 ± 3.7 minutes and 9.36 ± 7.65 minutes in bolus and infusion groups, respectively (P = .040). Furosemide bolus injection and infusion had no significant effect on creatinine, blood urea nitrogen, sodium and potassium.

CONCLUSION

Furosemide bolus injection can reduce diuresis onset time compared to furosemide infusion.

摘要

目的

呋塞米常用于增加肾移植患者的尿量。本研究比较了肾移植患者中呋塞米的两种给药途径(推注与输注)。

材料与方法

本临床试验纳入了2015年在伊朗大不里士一家医院接受肾移植的50例患者。他们被分为两组:推注组(单次静脉注射120mg)和输注组(4mg/分钟)。主要结局是利尿开始时间。次要结局包括尿量、生命体征(血压、心率)和电解质水平(肌酐、血尿素氮、钠和钾)。记录动脉和静脉吻合后动脉夹移除时间和利尿开始时间。最后,在吻合后用常规尿袋测量两组患者1小时的尿量。然后每3小时重复一次,持续24小时,此后最终在术后2天和3天重复测量。最后,对所有数据进行统计学分析。

结果

约72%的患者为男性(平均年龄37.15 ± 14.67岁)。推注组的尿量较高,但无统计学意义。在动脉夹松开后测量利尿持续时间,推注组和输注组的平均时间分别为5.41 ± 3.7分钟和9.36 ± 7.65分钟(P = .040)。呋塞米推注和输注对肌酐、血尿素氮、钠和钾无显著影响。

结论

与呋塞米输注相比,呋塞米推注可缩短利尿开始时间。

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