冠状动脉旁路移植术中体外循环对肾功能的影响

Effects of renal function under off-pump or conventional coronary artery bypass grafting

目的:了解冠状动脉旁路移植术中体外循环对病人肾功能损伤的影响。方法:689例行冠状动脉搭桥术患者按施行体外循环与否及体外循环时间进行分组。分析术前及术后的肾功能指标水平。结果:冠状动脉旁路移植术后肾功能指标:血肌酐(Cr)、尿素氮(BUN),尿α-微量蛋白(MG)各指标水平较术前均有明显升高(P<0.01).体外循环组较非体外循环组升高更明显(P<0.05～<0.01);体外循环时间超过150 min者的升高最明显(P<0.01)。结论:非体外循环CABG术对病人肾功能损害影响的小于有体外循环的CABG术,过长时间的体外循环时间对肾功能损害的影响更大。

Objective:To analysis the effects of renal function under off-pump or on-pump coronary artery bypass grafting (CABG). Methods:A total of 689 patients performed CABG were divided to off-pump groups (411 cases) and on-pump group(278 cases). Results: Levels of blood urea nitrogen (BUN), blood creatinine(Cr) , urine α-microglobulin (α-MG) after CABG deteriorated (P<0.01), those of on-pump group were worse (P<0. 05-<0. 01). When pump time was more 150 minutes the levels of BUN, Cr and α-MG were worse than those of pump time <150 minutes (P <0. 01). Conclusion: Negative effect on renal function of on-pump CABG is more than that of off-pump CABG;especially the pump time is more than 150 minutes.