老年冠状动脉搭桥术后平均动脉压 与急性肾损伤的关系

Relationship between postoperative mean arterial pressure and acute renal injury in elderly patients after coronary artery bypass grafting

摘要:

目的 讨论老年冠状动脉搭桥术后平均动脉压与急性肾损伤的关系。方法 选择250 例行体外循 环下冠状动脉搭桥的老年患者，根据术后平均动脉压分为4 组：66 ～ 70 mmHg 组、71 ～ 75 mmHg 组、76 ～ 80 mmHg、≥ 81 mmHg 组，回顾性比较各组的术后6 h 乳酸清除率、急性肾损伤发生率、住重症监护室 （ICU）时间、30 d 死亡率。结果 4 组患者间术后急性肾损伤发生率及30 d 死亡率比较，差异无统计学意义 （P >0.05）。平均动脉压71 ～ 75 mmHg 组较其他3 组患者的术后6 h 乳酸清除率高、住ICU 时间短，差异有 统计学意义（P <0.05）。结论 老年冠状动脉搭桥术后进一步提高高于65 mmHg 的平均动脉压并不能减少急 性肾损伤的发生率。

Abstract:

Abstract: Objective To discuss the relationship between postoperative mean arterial pressure and acute renal injury in elderly patients after coronary artery bypass grafting. Methods A total of 250 elderly patients undergoing coronary artery bypass grafting were divided into four groups according to the postoperative mean arterial pressure: 66-70 mmHg group, 71-75 mmHg group, 76-80 mmHg group, and ≥ 81 mmHg group. The 6-h lactic acid clearance rate, the incidence of acute renal injury, the length of ICU stay and the 30-d mortality were compared retrospectively among the groups. Results There was no significant difference in the incidence of acute renal injury or the 30-d mortality among the four groups (P > 0.05). The 6-h lactic acid clearance rate was the highest and the length of ICU stay was the shortest in the 71-75 mmHg group (P < 0.05). Conclusions Increasing the postoperative mean arterial blood pressure which is higher than 65 mmHg could not reduce the incidence of acute renal injury after coronary artery bypass grafting in the elderly.