呋塞米输注方式对肝移植术中肾功能的影响

Effect of deferent furosemide infusion modes on renal function during liver transplantation

目的比较术中应用分次输注和连续输注呋塞米对肝移植手术患者围术期肾功能的影响。方法合并不同程度肾功能受损的肝移植患者30例,根据术中输注呋塞米的方式不同均分为分次输注组(A组)和微泵输注组(B组)。记录术中血肌酐(Scr)、尿素氮(BUN)、内生肌酐清除率(Ccr)和尿量的变化。结果与术前比较,无肝期后A组Scr、BUN显著升高(P<0.01),新肝期30min至术后24hCcr显著降低(P<0.01);B组Scr、BUN仅在新肝期30min显著升高(P<0.01),Ccr在无肝期30min和新肝期30min明显降低(P<0.01)。结论微泵输注呋塞米较分次输注更有利于术前肾功能受损患者肝移植术中的肾功能保护。

Objective To evaluate continuous or bolus infusion of furosemide on renal function during liver transplantation.Methods Liver transplantation patients with impaired renal function were randomly divided into two group,one group（group A,15 patients） were given bolus infusion of furosemide,the other group（group B,15 patients） were given continuous infusion of furosemide.The hemodynamics,the plasma creatinine,urea nitrogen,urine volume,creatinine clearance rate were recorded.Results There is no significant difference in blood urea nitrogen and creatinine between the two groups before anesthesia.Scr,BUN during anhepatic phase in group A increased but decreased 30 min after neohepatic phase until 24 h postoperatively（P〈0.01）.Scr,BUN only increased 30 min after neohepatic phase in group B（P〈0.01）.Ccr decreased both at 30 min after anhepatic phase and 30 min after neohepatic phase.Conclusion Continuous infusion of furosemide can protect renal function during liver transplantation.