Welch M, Knight D G, Carr H M, Smyth J V, Walker M G
Department of Vascular Surgery, Manchester Royal Infirmary, United Kingdom.
Surgery. 1994 Jan;115(1):46-51.
This study was undertaken to determine the true incidence of renal impairment after aortic surgery and its association with intraoperative fluctuations in renal artery blood flow and cardiac output.
Direct measurements of renal artery blood flow were undertaken with electromagnetic flowmetry in 19 patients undergoing elective infrarenal aortic surgery. Renal function was assessed before and after operation by measurement of creatinine clearance.
Twelve patients (63%) had renal impairment as defined by a 40% or greater reduction in creatinine clearance after operation. This group of patients had significantly lower renal artery blood flow during the period of aortic cross-clamping than had those who preserved their renal function (p < 0.001).
Renal impairment is common after infrarenal aortic surgery and may be a result of intraoperative ischemia secondary to reduced renal artery blood flow.
本研究旨在确定主动脉手术后肾功能损害的真实发生率及其与术中肾动脉血流和心输出量波动的关系。
对19例接受择期肾下主动脉手术的患者采用电磁血流仪直接测量肾动脉血流。通过测量肌酐清除率评估术前和术后的肾功能。
12例患者（63%）术后肌酐清除率降低40%或更多，符合肾功能损害的定义。与肾功能正常的患者相比，该组患者在主动脉交叉阻断期间肾动脉血流显著降低（p<0.001）。
肾下主动脉手术后肾功能损害很常见，可能是肾动脉血流减少继发术中缺血的结果。
