心脏不停搏二尖瓣置换术对患者血尿素氮和血肌酐水平的影响

Effects of beating-heart mitral valve replacement on patients' levels of blood urea nitrogen and serum creatinine

目的对比心脏停搏和不停搏体外循环(CPB)二尖瓣置换术对患者肾功能的影响。方法需行二尖瓣置换术的患者40例,随机分为不停搏组和停搏组,每组各20例。检测术前(T1)、CPB后30 min(T2)、CPB后2 h(T3)、术后24 h(T4)、术后72 h(T5)血清尿素氮(BUN)、血肌酐(Scr)水平。结果术后不停搏组血清BUN、Scr水平低于停搏组(P<0.05),组内不同时间点的BUN、Scr水平差异有统计学意义(P<0.05),分组与时间之间有交互作用(P<0.05)。结论心脏不停搏手术较之停搏手术在一定程度上可减少对二尖瓣置换术患者肾功能的损害。

Objective To compare the effects of arrested-versus beating-heart mitral valve replacement with cardiopulmonary bypass（ CPB） on the patients′renal function.Methods Forty patients who needed mitral valve replacement were randomly divided into beating-heart group and arrested-heart group,with 20 case in each group.The levels of blood urea nitrogen（BUN） and serum creatinine （Scr） were detected preoperatively（T1）,30 minutes after CPB（T2）,2（T3）,24（T4） and 72 hours （T5） after CPB,respectively.Results After operation,the levels of BUN and Scr in the beating-heart group were lower than those in the arrested-heart group（P〈0.05）,there were significant differences in the levels of BUN and Scr at different time points in each group（P〈0.05）,and significant interaction effects were observed between different groups and times（P〈0.05）.Conclusion To some extent,beating-heart surgery may lead to less damages to renal function among patients who have undergone mitral valve replacement compared to arrested-heart surgery.