合并肾功能不全妇科患者围手术期处理

The perioperative management of gynecological patients with renal dysfunction

目的探讨合并肾功能不全的妇科患者围手术期处理措施。方法回顾性分析1997年1月～2009月4月在华中科技大学同济医学院附属同济医院妇产科进行手术的7例合并肾功能不全的患者的临床资料。结果7例患者中4例给予内科保守治疗,2例分别术前、术后给予血液透析,2例术前行右肾造瘘术,所有患者均安全度过围手术期,血肌酐、尿素氮手术后较术前差别无统计学意义。结论合并肾功能不全并非手术禁忌证,给予合理的处理措施可使患者安全度过围手术期,保护患者肾脏功能,防止肾功能不全继续恶化及相关并发症发生。

Objective To study the perioperative management of gynecological patients with renal dysfunction. Methods The clinical data of 7 cases of gynecological patients with renal dysfunction from Jan. 1997 to Apr. 2009 in Tongji Hospital, Tongji Medical College, HUST, were retrospectively analyzed. Results Seven patients survived through perioperative period safely. There were no significant differences in renal function including serum creatinine and urea nitrogen before and after operation. Among the patients, 4 cases received conservative medical management, 2 cases preoperative and postoperative hemodialysis, and 2 cases nephrostomy before gynecological operation. Conclusion Renal dysfunction is not a surgical contraindication. Reasonable perioperative management could prevent the occurrence of renal failure-related complications.