心脏术后应用碳酸氢钠治疗急性肾功能损伤

摘要

目的 研究碳酸氢钠在心脏术后出现血管麻痹综合征的患者中急性肾功能损伤的治疗措施.方法 149例患者出现了微循环障碍的患者,随机分为治疗组56例患者即运用血管活性药物(多巴胺≥5μg·kg-1·min-1)和碳酸氢钠,对照组93例患者仅运用血管活性药物量.结果 接受碳酸氢钠治疗的所有患者中,2例出现严重肾功能障碍并接受透析治疗(3.5％)；而未接受碳酸氢钠治疗的患者中,共7例出现了不同程度的肾功能障碍(7.5％),其中5例接受了透析治疗(5.3％),两组比较有统计学意义(P＜0.05).结论 应用碳酸氢钠及时纠正酸中毒能够改善心脏术后出现的血管麻痹综合征,减少血管活性药物的剂量,并能显著减少肾功能损伤等并发症的发生.%Objective To explore the role of NaHCO3 on the vasoplegic syndrome after cardiac postoperative and the treatments of acute kidney injury after cardiac surgery.Methods 149 patients undergoing cardiac surgery had different degrees of vascular hyporeactivity and microcirculation disturbance.56 patients of them received NaHCO3 therapy and received massive dosage of vasoactive drugs,while 93 patients received massive dosage of vasoactive drugs.Results 2 out of the patients who received NaHCO3 therapy suffered from acute kidney injury and had to accept hemodialysis(3.5％),7 out of the patients received massive dosage of vasoactive drugs had different degrees of acute kidney injury(7.5％) and 5 patients received hemodialysis(5.3％).Conclusion NaHCO3 therapy could improve the vascular hyporeactivity and decrease the incidence of acute kidney injury after cardiopulmonary bypass.