浙江医学2017，Vol.39Issue(24)：2250-2253,2256,5.DOI:10.12056/j.issn.1006-2785.2017.39.24.2016-2172
术中MAP水平对老年高血压患者术后急性肾损伤的影响研究
Impact of intraoperative mean arterial pressure on postoperative acute kidney injury in elderly patients with hypertension
吴秀娟 1蒋宗明 2王时敏 1沈水娟 1吕安庆 2陈忠华2
作者信息
- 1. 312000 绍兴市人民医院(浙江大学绍兴医院)肾内科
- 2. 312000 绍兴市人民医院(浙江大学绍兴医院)麻醉科
- 折叠
摘要
Abstract
Objective To investigate the impact of intraoperative mean arterial pressure (MAP) on postoperative acute kidney injury (AKI) during major gastrointestinal surgery in elderly patients with chronic hypertension.Methods Four hundred and eighty elderly patients with chronic hypertension undergoing gastrointestinal surgery were randomly allocated to two groups with 240 in each group:in group Ⅰ the intraoperative MAP of patients was controlled to 65～85 mmHg and in group Ⅱ the intraoperative MAP was controlled to 86～100 mmHg.Intraoperative parameters,postoperative AKI occurrence and length of hospital stay were observed and compared between two groups.Results There were no significant differences in anesthesia time,duration of surgery and volume of crystalloids,colloids,plasma and red blood cell infusion,and intraoperative blood loss between two groups (all P ＞0.05).Compared to group Ⅰ,group Ⅱ had higher doses of norepinephrine,phenylephrine and nitroglycerin (all P＜0.05).Consequently,group Ⅱ had more frequent intraoperative sinus bradycadia and premature atrial beats (all P＜0.05).However,compared to group Ⅰ,there were lower incidence of postoperative AKI and rate of ICU admission,and shorter length of ICU stay and hospital stay (all P＜0.05) in group Ⅱ.Conclusion For elderly patients with hypertension undergoing gastrointestinal surgery,maintaining a higher intraoperative MAP level decreases postoperative AKI rate and confers beneficial effect on kidney function.关键词
平均动脉压/高血压/急性肾损伤/老年Key words
Mean arterial pressure/Hypertension/Acute kidney injury/Elderly引用本文复制引用
吴秀娟,蒋宗明,王时敏,沈水娟,吕安庆,陈忠华..术中MAP水平对老年高血压患者术后急性肾损伤的影响研究[J].浙江医学,2017,39(24):2250-2253,2256,5.
