心脏换瓣术后早期急性肾功能衰竭的危险因素探讨

Probe into Risk Factors of Early Acute Renal Failure After Cardiac Valve Replacement

目的 探讨心脏换瓣术后早期急性肾功能衰竭的危险因素。方法 对１８例心脏换瓣术后早期ＡＲＦ患者的临床资料进行分析。结果 术中血流阻断时间≤８０ ｍｉｎ与＞８０ ｍｉｎ、术后有无合并低心排，ＡＲＦ的发生率均有显著性差异，Ｐ＜０． ０５．结论ＡＲＦ的发生与围手术期有关危险因素有密切关系。预防ＡＲＦ主要从术前充分改善心功能，以确保术程顺利，缩短术中阻断主动脉血流时间，术后保持充足的血容量和良好的循环功能及密切监测肾功能着手。

Objective To probe the risk factors of early acute renal failure(ARF)after cardiac valve replacement(CVR). Methods Clinical data of 18 cases with ARF after CVR were analyzed. Results Block of the blood flow ≤80 min, or>80 min during the operation,the patients with low cardiac output were risk factors in the occurrence of ARF (P<0. 05). Conclusions There was close relation between the occurrence of ARF and relevant risk factors pre- and post-operation. Prevention of ARF should be started from pre-operative improvement of cardiac function so as to assure the smooth operation and reduce the time for the block of blood flow in the aorta during the operation and to reserve enough blood volume for good circulatory function after operation and close supervision of renal failure should also be undertaken.