瓣膜病变合并肾功能不良患者的体外循环管理

目的：探讨瓣膜病变合并肾功能不良患者的体外循环管理方法。方法：2003年1月～6月在我院接受瓣膜置换术且术前肾功能检查指标异常的15名患者作为研究组，2002年1月～6月符合上述条件的18名患者作为对照组。两组患者体外循环管理的不同之处在于：研究组患者在体外循环中应用平衡超滤，严格选用抗生素，少用或不用人工胶体，不用甘露醇，体外循环中避免肾缺血。结果：研究组患者术后肾功能明显好于对照组。结论：在研究组患者中应用的上述措施对术前就用肾功能损伤的患者是有帮助的。

The Management of Cardiopulmonary Bypass on the Patients with valve diseases and renal dysfunction

Objective:To investigate the management of cardiopulmonary bypass (CPB) on the patients with valve diseases and renal dysfunction.Methods:The patients who accepted valve replacement from Jan.to Jun.2003 and suffered from renal dysfunction acted as the study group.Another patients who accepted valve replacement from Jan.to Jun.2002 and troubled with renal dysfunction acted as the control group.The difference of the CPB management between the study group and the control group is that the man-made colloid,mannitol and antibiotic with renal toxicity was avoided and the balanced ultrafiltraiton was used.Results:After surgery,the renal function of the patients in the study group was better distinctly than that of the patients in the control group.Conclusions:The measures done with these patients in the study group is in favor of the patients with renal dysfunction.