体外循环与非体外循环下行CABG对肾功能不全患者肾功能影响的比较

Comparison of on-pump and off-pump coronary artery bypass in patients with renal insufficiency

目的:比较在体外循环与非体外循环下行冠状动脉旁路移植术(CABG)对患者肾功能的影响。方法:我院40位择期行CABG的慢性肾功能不全患者,随机分为两组,每组20例,分别在在体外循环与非体外循环下行CABG。术前及术后1、3、7 d测定血肌酐值并计算肌酐清除率。结果:体外循环组患者术后血肌酐值显著高于非体外循环组,其肌酐清除率较术前显著下降。结论:肾功能不全患者在体外循环与非体外循环下行CABG,前者更易加重肾功能损害。

AIM： To compare the effect of on-pump and off-pump coronary artery bypass surgery in patients with chronic renal insufficiency. METHODS： Forty patients with chronic renal insutticiency who underwent elective surgery were divided randomly into two groups： on-pump cardiopulmonary bypass group （OCPB） （ n = 20） and off-pump CPB group （ n = 20）. Serum creatinine （Scr） was detected and creatine clearance （Ccr） was calculated before and 1, 3 and 7 days after operation. RESULTS ： After surgery, Scr in OCPB group was obviously higher than in off-pump CPB group and Ccr was strikingly lower compared with preoperative values. CONCLUSION： Compared with off-pump coronary artery bypass, on-pump coronary artery bypass is more likely to aggravate renal dysfunction in patients with chronic renal insufficiency.