体外循环与非体外循环下行CABG对肾功能不全患者肾功能影响的比较

Comparison of on-pump and off-pump coronary artery bypass in patients with renal insufficiency

摘要: 目的:比较在体外循环与非体外循环下行冠状动脉旁路移植术（CABG）对患者肾功能的影响。方法：我院40位择期行CABG的慢性肾功能不全患者，随机分为两组，每组20例，分别在在体外循环与非体外循环下行CABG。术前及术后1、3、7 d测定血肌酐值并计算肌酐清除率。结果：体外循环组患者术后血肌酐值显著高于非体外循环组，其肌酐清除率较术前显著下降。结论：肾功能不全患者在体外循环与非体外循环下行CABG，前者更易加重肾功能损害。

Abstract: AIM:To compare the effect of on-pump and off-pump coronary artery bypass surgery in patients with chronic renal insufficiency. METHODS: Forty patients with chronic renal insufficiency who underwent elective surgery were divided randomly into two groups: on-pump cardiopulmonary bypass group (OCPB) (n=20) and off-pump CPB group (n=20). Serum creatinine (Scr) was detected and creatine clearance (Ccr) was calculated before and 1, 3 and 7 days after operation. RESULTS: After surgery, Scr in OCPB group was obviously higher than in off-pump CPB group and Ccr was strikingly lower compared with preoperative values. CONCLUSION: Compared with off-pump coronary artery bypass, on-pump coronary artery bypass is more likely to aggravate renal dysfunction in patients with chronic renal insufficiency.