肾移植术中受者血压对移植肾的影响

The effect of blood pressure of recipients on the grafted kidney during renal transplantation

慢性肾功能衰竭行肾移植术者３９例，按手术中移植肾开放血流时受者的平均动脉压分为３组。Ａ组Ｂｐ１６．８～２２．８ｋＰａ；Ｂ组Ｂｐ１０．７～１６．７ｋＰａ；Ｃ组：Ｂｐ７．０～９．８ｋＰａ，观察血流开放后移植肾的情况。结果，Ａ组移植肾有较高的血管痉挛率，为５７．１４％，Ｂ组为９．０９％，Ｃ组无此现象，其发生率Ａ组与Ｂ组间的差异有极显著性（Ｐ＜０．０１）。Ｃ组移植肾均充盈不良。Ａ、Ｂ、Ｃ各组移植肾恢复血流后开始排尿的时间分别为１５．６３±６．２１分、５．２２±１．３３分和２２．３１±４．４５分，Ａ、Ｃ组均明显长于Ｂ组（Ｐ＜０．０５）。认为肾移植术中受者血压的高低对移植肾可产生影响，最适血压范围为１０．７～１６．７ｋＰａ。

Thirty-nine patients with chronic renal failure undergoing renal transplantation were divided into three groups according to the mean blood pressure of the recipients as the blood flow being opened during operations. Group A: 16.8 ￣ 22.8 kPa, Group B: 10.7 ￣ 16.7 kPa; Group C: 7.0 ￣ 9.8 kPa. The functional status of the grafted kidney was observed after blood flow being opened. The results showed that the vasospasm rate of the grafted kidney in group A was 57.14% , higher than 9.09% in group B, with a remarkable difference between group A and group B ( P < 0.01 ). All of the grafted kidneys in group C were poor filling. The time of initial urination of the grafted kidneys in group A, B and C after the blood flow being opened was 15.63 ± 6.21 min, 5.22 ± 1.33 min and 22.31 ± 4.45 min, respectively. The time in group A and C was significantly longer than in group B ( P < 0.05 ). It was concluded that the optimal range of recipient's blood pressure during the renal transplantation was 10.7 ￣ 16.7 kPa.