6羟乙基淀粉130/0.4对老年食管癌手术患者肾功能的影响

摘要

目的 探讨6%羟乙基淀粉130/0.4对老年食管癌手术患者肾功能的影响.方法 选择择期行食管癌手术的老年患者54例,随机分为两组各27例,均行急性高容量血液稀释(acute hypervolemic hemodilution,AHH).治疗组静脉滴注6%羟乙基淀粉130/0.4氯化钠注射液,对照组静脉滴注乳酸钠林格注射液.监测AHH前(t1),AHH完成时(t2),AHH后2 h(t3)、4 h(t4)和24 h(t5)心率(heart rate,HR)、动脉血氧饱和度(saturation of arterial blood oxygen,SaO2)、平均动脉压(mean arterial pressure,MAP)、中心静脉压(central venous pressure,CVP)及血尿素氮(blood urea nitrogen,BUN)、肌酐(creatinine,Cr)、尿酸(uric acid,UA)和半胱氨酸蛋白酶抑制剂C(cysteine protease inhibitors C,Cystatin-C)水平.结果 2组患者各时间点HR和MAP比较差异无统计学意义,2组CVP在t2、t3和t4时点均较t1和t5明显升高,治疗组CVP t2、t3和t4时点较对照组高.2组Cr、BUN和UA各时间点组间和组内比较均差异无统计学意义,2组患者Cys-C在t5时间点均较t1、t2、t3和t4时间点升高,但组间差异无统计学意义.结论 6%羟乙基淀粉130/0.4行术前AHH对老年食管癌患者肾功能无明显影响.%Objective To explore the influence of 6％ hydroxyethyl starch 130/0.4 on renal function of elderly patients undergoing esophageal cancer surgery. Methods The 54 elderly patients received esophageal cancer surgery were enrolled and randomly divided into two groups and undertook acute hypervolemic hemodilution( AHH ). 6％ hydroxyethyl starch 130/0.4 sodium chloride injection and sodium lactate ringer's injection were given to the test and control groups, respectively. The heart rate( HR ), saturation of arterial blood oxygen( SaO2 ), mean arterial pressure( MAP ), central venous pressure( CVP ), creatinine ( Cr ),blood urea nitrogen( BUN ),uric acid( UA )and Cysteine protease inhibitors C( Cystatin-C ) were monitored at before AHH ( t1 )、post AHH( t2 )、2 hours after AHH( t3 )、4 hours after AHH(t4 ) and 24 hours after AHH( t5 ). Results There was no significant difference occured for MAP and HR between the two groups. CVP in both groups was increased significantly at t2-t4 compared with that at t1 and t5. CVP in the test group was higher than that in the control group at t2, t3 and t4. No remarkable changes for Cr,BUN and UA were found whatever time points, inter-groups or intra-groups. Serum concentrations of were normal during the study. Cys-C at t5 in both groups were higher than that at t1 -t4, and there was no significant difference between two groups. Conclusion AHH with 6％ hydroxyethyl starch 130/0.4 has no obvious harmful effect on renal function of the elderly patients who undertaken surgical treatment for esophageal cancer.