体外膜肺氧合对心脏死亡后捐献的供肾保护的研究

Research on Extracorporeal Membrane Oxygenation for the Donor Kidney Protection after Cardiac Death

目的分析心脏死亡后捐献供肾保护中应用体外膜肺氧合处理方法的效果。方法将整群选取2014年3月—2015年6月该院心脏死亡后捐献肾脏器官病例资料40例纳入研究。随机分对照组、实验组,每组患者20例。对照组采用常规护理方法,实验组采用体外膜肺氧合处理方法。对比观察供肾保护效果。结果实验组肾功能延迟恢复、急性排斥性反应发生率分别为5.00%(1/20)、10.00%(2/10),无移植肾无功能患者,以上发生率均明显低于对照组(P<0.05)。实验组移植肾术后1 d平均肌酐值为(94.3±16.8)umol/L、肾功能平均恢复时间为(5.8±0.3)d,均明显低于对照组;平均尿量值为(3505.6±263.9)m L,明显高于对照组(P<0.05)。结论体外膜肺氧合可提高心脏死亡后捐献肾脏的整体质量,是供肾保护的重要手段。

Objective To analyze the effect of the application of the treatment method of extracorporeal membrane oxygenation for the donor kidney protection after cardiac death. Methods 40 cases donating kidneys after cardiac death in our hospital from March 2014 to June 2015 were selected and randomly divided into two groups with 20 cases in each, the control group were treated with the routine nursing method, the experimental group were treated with the treatment method of extracorporeal membrane oxygenation, the donor kidney protection effect of the two groups was compared and observed. Results The incidences of delayed recovery of kidney function, acute rejection and non-functional transplanted kidney were respectively 5.00%（1/20）, 10.00%（2/10）and 0.00% in the experimental group, which were obviously lower than those in the control group（P〈0.05）, on the 1d after the kidney transplantation, the mean creatinine value and the average recovery time of kidney function were respectively（94.3±16.8）umol/L and（5.8±0.3）d, which were obviously lower than those in the control group, the average value of urine volume in the experimental group was（3505.6 ±263.9）ml, which was obviously higher than that in the control group（P〈0.05）. Conclusion The extracorporeal membrane oxygenation can improve the total body mass of the donor kidney after cardiac death, and it is an important means of the donor kidney protection.