Brenowitz J B, Williams C D, Edwards W S
Am J Surg. 1977 Dec;134(6):765-9. doi: 10.1016/0002-9610(77)90320-8.
To determine the risks of performing major surgical procedures on patients with chronic renal failure, the charts of twenty-nine hemodialysis patients who underwent thirty-eight elective and nine emergency operations were reviewed. Preoperative preparation included adequate hemodialysis of the patients, 88 per cent of whom were dialyzed within 24 hours of surgery. Azotemia was well controlled prior to administration of anesthesia. The average preoperative hematocrit was 26 per cent, and only one patient was hyperkalemic preoperatively. There were no intraoperative complications attributable to the patients' impaired renal function. Postoperative complications were frequent and are discussed in detail. Hemodialysis was done immediately postoperatively in five patients and on the first postoperative day in twenty-three additional patients with no problems. There were only two deaths (4.3 per cent) in the series. With careful monitoring during the perioperative period, major surgical procedures can safely be performed on patients with chronic renal failure.
为了确定对慢性肾衰竭患者实施大型外科手术的风险，我们回顾了29例接受血液透析的患者的病历，这些患者共接受了38例择期手术和9例急诊手术。术前准备包括对患者进行充分的血液透析，其中88%的患者在手术前24小时内进行了透析。在给予麻醉之前，氮质血症得到了很好的控制。术前平均血细胞比容为26%，术前只有1例患者血钾过高。没有因患者肾功能受损而导致的术中并发症。术后并发症很常见，将详细讨论。5例患者术后立即进行了血液透析，另外23例患者在术后第一天进行血液透析，均未出现问题。该系列中仅有2例死亡（4.3%）。在围手术期进行仔细监测的情况下，可以安全地对慢性肾衰竭患者实施大型外科手术。
