三种左室功能辅助器植入后对患者肾功能影响的对比分析

Renal Function after Using Three Different Types of Left Ventricular Assist Devices

目的探讨三种不同种类的左室功能辅助器(LVAD)植入后对患者肾功能的影响。方法回顾性分析23例行LVAD植入术的患者,按植入器种类不同分为3组:A组(n=12)Toyobo;B组(n=8)Novacor和C组(n=3)HeartMate。比较3组患者的ICU停留时间及术后第1、3、7天血尿素氮(BUN)、肌酐和肌酐清除率(CrCl)水平。结果3组患者在ICU停留的时间分别为:(17±15)d、(12±9)d、(11±8)d,3组比较差异无统计学意义(P=0.546)。3组患者术后第1、3、7天BUN、肌酐和CrCl水平比较差异均无统计学意义(P>0.05)。A组有2例患者在LVAD植入后因肾功能不全接受血液滤过,B组和C组患者术后均未行血液滤过。结论3组患者术后第1、3、7天的BUN、肌酐和CrCl水平无差异。但植入ToyoboLVAD的患者可能更倾向于出现肾功能不全。

Objective To investigate the impact on renal function after implantation of three different types of left ventricular assist device(LVAD).Methods Twenty-three patients undergoing LVAD implantation were retrospectively analyzed and categorized into 3 groups based on the different LVAD pump implanted:Group A(n=12)Toyobo,Group B(n=8)Novacor and Group C(n=3)HeartMate.The levels of blood urea nitrogen(BUN),creatinine and creatinine clearance(CrCl)in the duration of ICU and on postoperative day 1,3 and 7 among the patients in the 3 groups were compared.Results The ICU staying time of the patient in the three group were(17 ± 15)d,(12 ± 9)d,and(11 ± 8)d respectively,with a significant difference among the three groups(P=0.546).The levels of BUN,creatinine and CrCl on postoperative day 1,3 and 7 among the patients in the 3 groups showed no significant difference(P>0.05).There were 2 patients in group A,because of renal insufficiency,received hemofiltration after LVAD implantation;while no patient in group B and C needed hemofiltration.Conclusion No significant difference was found in levels of BUN,creatinine and CrCl on postoperative day 1,3 and 7 among the patients in the 3 groups.However,patients using Toyobo LVAD tend to have renal dysfunction.