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接受腹主动脉血管重建术的患者,术中尿量并不能预测术后肾功能。

Intraoperative urinary output does not predict postoperative renal function in patients undergoing abdominal aortic revascularization.

作者信息

Alpert R A, Roizen M F, Hamilton W K, Stoney R J, Ehrenfeld W K, Poler S M, Wylie E J

出版信息

Surgery. 1984 Jun;95(6):707-11.

PMID:6427960
Abstract

To determine whether intraoperative urinary output was predictive of postoperative renal function, mean urinary output and lowest hourly urinary output were measured in 137 patients during operation for aortic reconstruction. Pulmonary capillary wedge pressure was kept within normal limits. If urinary output was less than 0.125 ml X kg-1 X hr-1, patients were given crystalloid solution, mannitol, furosemide (Lasix), or nothing. For each patient, serum creatinine and blood urea nitrogen (BUN) levels were assayed on postoperative days 1, 3, and 7. There was no significant correlation between intraoperative mean urinary output or lowest hourly urinary output and change from preoperative to postoperative levels of creatinine or BUN. Twenty-one patients had postoperative renal insufficiency; of these, 17 had had renal disease before operation. In these patients as well; mean urinary output and the lowest hourly urinary output did not correlate with change in BUN or creatinine levels. The position of the aortic cross-clamp did not affect these correlations. Therefore, intraoperative urinary output was not predictive of postoperative renal insufficiency in patients undergoing aortic reconstruction.

摘要

为了确定术中尿量是否可预测术后肾功能,在137例接受主动脉重建手术的患者术中测量了平均尿量和最低每小时尿量。肺毛细血管楔压维持在正常范围内。如果尿量低于0.125 ml×kg⁻¹×hr⁻¹,患者会接受晶体溶液、甘露醇、呋塞米(速尿)治疗,或者不进行处理。对每位患者在术后第1天、第3天和第7天测定血清肌酐和血尿素氮(BUN)水平。术中平均尿量或最低每小时尿量与术前至术后肌酐或BUN水平的变化之间无显著相关性。21例患者出现术后肾功能不全;其中17例术前有肾脏疾病。在这些患者中,平均尿量和最低每小时尿量也与BUN或肌酐水平的变化无关。主动脉交叉钳夹的位置不影响这些相关性。因此,术中尿量不能预测接受主动脉重建手术患者的术后肾功能不全。

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