肾移植术中血压对早期移植肾功能的影响

The effect of blood pressure in operation on the early function of grafted kidney

目的 :探讨肾移植术中移植肾血流开放时血压对早期移植肾功能的影响。方法 :通过观察移植肾血流开放后移植肾的颜色、质地 ,开始排尿时间 ,术后第 1、2天血肌酐检测值 ,急性肾小管坏死 (ATN)的发生率 ,探讨术前不同血压水平患者在移植肾血流开放后血压变化对移植肾功能的影响。结果 :血流开放时平均动脉压(MAP)与术前MAP比值不低于 0 .90组 ,开始排尿时间为 3.95± 2 .14min ,ATN发生率为 5 % ,血肌酐术后第 1天为32 6± 15 7μmol/L ,第 2天为 2 0 6± 14 2 μmol/L ;血流开放时MAP与术前MAP的比值低于0 .90组 ,开始排尿时间为9.2 5± 4 .86min ,ATN发生率为 11% ,血肌酐术后第 1天为 4 14± 173μmol/L ,第 2天为 2 6 3± 14 8μmol/L。 结论 :移植肾血流开放时血压的改变对早期移植肾功能有一定影响。

Purpose:To observe the effect of blood pressure on the early function when bloodstream is opened. Method:The color and character of grafted kidney, time of initial urination, the creatine in the first and second day posttransplant and ATN were observed. Results:The patients were divided into two groups according to the ratio of the MAP when bloodstream was opened and the MAP before operation. In the two groups in which the ratio was no under 90% and under 90%,the time of initial urination was 3.95 ± 2.14 min and 9.25 ± 4.86 min; the ratio of ATN was 5% and 11%; the creatine was 326±157 μmol/L and 414±173μmol/L in the first day posttransplant, 206±142μmol/L and 263±148μmol/L in the second day. Conclusion:The MAP when bloodstream is opened has some influence on the early function of grafted kidney.