冠脉搭桥围术期血肌酐变化及络达嗪对术后肾功能的改善作用

Serum Creatinine Change Peri-Operation and Effect of Ligustrazin Injection to Renal Function Postoperative Coronary Artery Bypass

目的:探讨冠状动脉搭桥围术期血肌酐变化及络达嗪对术后肾功能的改善作用。方法:根据术前血肌酐水平是否超过136mmol/L,分为肾功能正常组和肾功能不全组,随机检测术前、术后当天、术后第1天、术后第3天、术后第5天和术后第7天血肌酐水平,根据尿量的多少,静脉应用速尿、利尿合剂或合并应用络达嗪注射液,以保证基本正常的尿量,观察围手术期血肌酐的动态变化。结果:肾功能不全组术前术后各时点血肌酐水平均超过正常范围,且均显著高于肾功能正常组,术后第3天和第5天血肌酐水平较术前明显升高,而肾功能正常组则围术期血肌酐处于正常范围。络达嗪注射液可减少速尿的用量。结论:对术前肾功能不全者冠状动脉搭桥手术对肾功能有影响,但经适当处理可逐渐恢复正常,而对术前肾功能正常者则无明显影响。络达嗪注射液对术后肾功能有改善作用,能减少速尿的用量。

Objective：To explore serum creatinine change peri-operation and the effect of ligustrazin injection to renal function postoperative coronary artery bypass.Methods： 107 cases were divided two groups,normal renal function group（n=89） and abnormal renal function group（n=18）,the serum creatinine level was detected at preoperational,operation day,1 day,3 day,5 day and 7day post operation.The abnormal renal function group（n=18） was divided into two subgroups,lasix group and lasix ＋ ligustrazin group,the two subgroups were given lasix and lasix ＋ ligustrazin injection to guarantee normal urine amount.Result： the serum creatinine level at every time point exceeded normal level and elevated more obviously at abnormal renal function group than normal renal function group.The serum creatinine level in normal renal function group was normal peri-operation.ligustrazin injection could decrease the amount of lasix.Conclusion： The coronary artery bypass could affect the renal function of the patients with preoperative abnormal renal function,but the serum creatinine level could recover normal through proper treatment.ligustrazin injection could improve the renal function postoperation of coronary artery bypass.