60岁以上患者体外和非体外循环冠状动脉旁路移植术后早期肾功能损伤研究

摘要

Objective To study the impact of the off -pump coronary artery bypass grafting compared to the conventional on -pump coronary artery bypass grafting on the rate of acute kidney injury in patients aged over 60.Methods The clinical data of 95 patients accepted coronary artery bypass surgery was retrospec-tively analyzed.Patients were divided into two groups,44 patients in on -pump group and 51 patients in off -pump group.Ser-um creatinine was measured in patients of both groups before and after surgery(1 ,2,3 d and 7 d).Then the levels of serum cre-atinine and acute kidney injury incidences in the two groups were compared.Results Serum creatinine levels in the CCABG group was significantly higer than that in the OPCAB group after surgery(1 ,2,3 d and 7 d)(P <0.05),which peaked in 2 days and 1 day later separately.5 patients in the off -pump group occurred AKI and 1 1 patients in the on -pump group occurred AKI,differences between the two groups was statistically significant(P <0.05).Conclusion Off -pump coronary artery bypass grafting is better than on -pump coronary artery bypass grafting in protecting the renal functions for patients aged over 60.%目的：探讨体外及非体外循环两种冠状动脉旁路移植术式对60岁以上患者术后早期急性肾功能损伤的影响。方法回顾性分析95例择期行冠状动脉旁路移植术治疗的患者的临床资料，其中非体外循环下冠状动脉旁路移植术患者51例（OPCAB 组），常规体外循环下冠状动脉旁路移植术患者44例（CCABG 组），检测术前，术后1、2、3 d 和术后7 d的血清肌酐值（Cr）。观察两组患者术后肌酐变化情况。结果两组患者术前血清 Cr 水平差异无统计学意义（P ＞0.05）。CCABG 组术后肌酐值高于 OPCAB 组（P ＜0.05），OPCABG 组肌酐水平在1 d 后达到高峰值，CCABG 组在2 d 后达高峰值。OPCAB 组发生5例急性肾功能损伤（AKI），CCABG 组发生11例 AKI，差异有统计学意义（P ＜0.05）。结论对于60岁以上患者，非体外循环冠状动脉旁路移植术对患者肾功能保护更有利。