Iwase K, Onishi K, Kobayashi J, Nishimura M, Kuroda O, Kobayashi Y
Department of Cardiovascular Surgery, Osaka Prefectural Hospital, Japan.
Nihon Geka Gakkai Zasshi. 1987 Oct;88(10):1479-84.
Effects of various factors before and during operation on postoperative renal hypofunction were studied in 34 preoperatively evaluated surgical cases of non-ruptured abdominal aneurysm. The cases were divided into two groups, with and without postoperative renal hypofunction. The two groups showed no differences with respect to age, sex, preoperative serum Crn or Ccr level, presence or absence of treatment with antihypertensives or diabetes mellitus, duration of intraoperative aortic clamping, or the volume of blood loss or transfusion. However, the group with postoperative renal hypofunction included many cases of preoperative hypertension. The incidence of postoperative renal hypofunction was high among cases which exhibited preoperative hypertension, but was low among those with preoperative normal blood pressure. Further, renal hypofunction occurred in few of the patients whose blood pressure had been controlled by the use of antihypertensives. The possibility was suggested that in palliative operations, preoperative blood pressure control, was useful for the prevention of postoperative renal hypofunction.
在34例术前评估的非破裂性腹主动脉瘤手术病例中，研究了手术前及手术过程中各种因素对术后肾功能减退的影响。这些病例被分为两组，即有和没有术后肾功能减退的组。两组在年龄、性别、术前血清肌酐或肌酐清除率水平、是否接受抗高血压治疗或糖尿病、术中主动脉阻断时间、失血量或输血量方面均无差异。然而，术后肾功能减退组中术前高血压病例较多。术前高血压患者术后肾功能减退的发生率较高，而术前血压正常者发生率较低。此外，使用抗高血压药物控制血压的患者中很少发生肾功能减退。提示在姑息性手术中，术前控制血压有助于预防术后肾功能减退。
