新活素静脉泵入对冠状动脉搭桥术后患者急性肾损伤的防治作用观察

发布时间：2018-05-19 02:35

本文选题：新活素 + 冠脉搭桥术　；参考：《山东医药》2017年39期

【摘要】：目的观察新活素静脉泵入对冠状动脉(冠脉)搭桥术后急性肾损伤(AKI)的防治作用。方法行择期冠脉搭桥术且安置脉搏指示连续心排量监测导管的患者123例,分为观察组52例和对照组71例。观察组转入重症医学科(ICU)后即给予新活素静脉泵入,新活素配置浓度为10μg/m L,负荷剂量为1.5μg/kg,维持剂量0.01μg/(kg·min),持续48 h。对照组转入后除常规治疗外给予生理盐水0.15 m L/kg静注后按0.06 m L/kg静脉持续泵入,持续48 h。记录转入ICU时及转入后24、48、72 h血肌酐水平;转入ICU时及转入后48 h心脏指数(CI);转入ICU后24、48、72 h显性液体出入量;转入ICU时及转入后72 h血脑钠肽(BNP)水平;术后AKI发生率;术后机械通气时间、ICU住院时间;术后7 d病死率。结果观察组转入ICU后48、72 h血肌酐水平低于对照组(P均0.05)。观察组转入ICU后48 h CI高于对照组(P0.05)。观察组转入ICU后72 h内显性液体负平衡量高于对照组,血BNP水平低于对照组(P均0.01)。观察组机械通气时间及ICU住院时间较对照组显著缩短(P均0.05)。观察组冠脉搭桥术后AKI发生率较对照组显著降低(P0.05)。结论新活素用于冠脉搭桥术后患者可减轻肾损伤,降低冠脉搭桥术后AKI的发生率。
[Abstract]:Objective to observe the preventive and therapeutic effects of intravenous infusion of neovasin on acute renal injury (AKI) after coronary artery bypass grafting (CABG). Methods 123 patients who underwent selective coronary artery bypass grafting and placed continuous cardiac output monitoring catheter with pulse indication were divided into observation group (n = 52) and control group (n = 71). The observation group received intravenous infusion of neovasin immediately after being transferred to the department of intensive care. The concentration of neovasin was 10 渭 g / mL, the loading dose was 1.5 渭 g / kg, and the maintenance dose was 0.01 渭 g/(kg / min for 48 h. In the control group, 0. 15 m L/kg saline was injected intravenously according to 0.06 m L/kg for 48 h, in addition to routine treatment. Serum creatinine levels were recorded at ICU and 24 h after transfer, cardiac index during ICU and 48 h after transfer, dominant fluid volume at 24 h 48 h after ICU, BNPs in blood brain natriuretic peptide (BNP) at ICU and 72 h after transfer, incidence of AKI after operation. The time of postoperative mechanical ventilation was longer than that of ICU, and the mortality was 7 days after operation. Results the serum creatinine level in the observation group was lower than that in the control group at 72 h after ICU transfer (P < 0.05). The CI of the observation group was higher than that of the control group at 48 h after ICU. In the observation group, the apparent liquid negative level was higher than that in the control group within 72 hours after the transfer to ICU, and the level of blood BNP was lower than that in the control group (P < 0.01). The time of mechanical ventilation and the hospitalization time of ICU in the observation group were significantly shorter than those in the control group. The incidence of AKI after coronary artery bypass grafting in the observation group was significantly lower than that in the control group. Conclusion Neoactin can alleviate renal injury and reduce the incidence of AKI after coronary artery bypass grafting.
【作者单位】：成都市第三人民医院;
【基金】：成都市医药卫生科研基金项目(2014064)
【分类号】：R654.2;R692

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