尸体肾移植术手术中液体的使用

How to use liquid and drug in cadaveric renal transplantation

目的探讨肾移植过程中维持较高的血压(Bp)和中心静脉压(CVP)的方案。方法开放移植肾血流前以患者Bp和CVP为标准对30例尸肾移植术预充以胶体溶液为主的容量负荷,术中给予扩张血容量和肾动脉内注射血管扩张剂,吻合血管开通后立刻从肾动脉内注入异搏定5～10mg。结果开放肾血流时间在手术开始后60～110min(82±28.5min),共输入白蛋白10g,双管同时输入1∶1的晶胶液各为(635±145.7)ml,浓缩红细胞平均1.45u,监测患者Bp和CVP在围术期能维持稳定在较高的水平,无肺水肿和心衰发生。结论肾移植开放肾血流前,适当的预先补充以胶体溶液为主的容量负荷,能保证围术期Bp和CVP的维持与稳定。

Objective To maintain blood pressure（BP）and central venous pressure（CVP）at higher levels during kidney transplantation. Methods Major standardization of priming solution volume load by observation of NIBP and CVP before blood supply to new kidney. Results Time of blood supply to new kidney about 60-110min（82±28.5min）after operation. Before blood supply to new kidney totally i. e. by drip Albumin 10g,simultaneously double tube i. e. by drip 1 ： 1 （635±145.7）ml crystal--solution and colloidal solution respectively, RBC average 1.45u,monitoring BP and CVP of the patient that could sustain stabilization at higher levels, without pulmonary edema and heart failure occurred. Conclusions Major properly priming colloidal solution volume load before blood supply to new kidney could ensure maintenance and stabilization of BP and CVP during kidney transplantation.