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目的:本研究运用临床无创的彩色多普勒血流显像作为研究手段,探讨肾血流在儿童和成人体外循环(CPB)术后改变特点。方法:对12例儿童和12例成人心脏病患者,在实施CPB心脏直视手术前,术后1 h、2 h、4 h、8 h、16 h、24 h,运用彩色多普勒血流显像分别监测各时点肾主动脉、肾段动脉阻力指数(RI),并同时检测肾功能尿素氮(Urea)、尿酸(UA)、肌酐(Crea),对所有数据进行统计分析。结果:儿童组患者肾功能各指标在术后8 h、16 h、24 h较术前明显增高,在16 h后肾功能逐渐趋于好转;成人肾功能在术后也呈现增高趋势,但通过统计分析差异不具有统计学意义。通过检测两组患者术后RI值均存在改变,术后1 h检测肾血流RI即发生明显增高,后逐渐恢复;儿童组较成人组RI改变更为明显。结论:体外循环术后1 h肾血流RI即明显增高,对于儿童肾脏功能和肾血流RI改变较成人更明显。
Objective: In this study, clinical non-invasive color Doppler flow imaging as a research tool to explore the renal blood flow in children and adults after cardiopulmonary bypass (CPB) changes in the characteristics. Methods: Twelve children and 12 adult patients with cardiac disease underwent color Doppler flow imaging before operation, 1 h, 2 h, 4 h, 8 h, 16 h, 24 h after CPB. The renal artery and renal artery resistance index (RI) were monitored at different time points, and renal function urea (Urea), uric acid (UA) and creatinine (Crea) were detected simultaneously. All the data were analyzed statistically. Results: The indexes of renal function in children group were significantly higher than preoperative levels at 8 h, 16 h and 24 h after operation, and renal function gradually tended to be improved after 16 h. The renal function of adult children also showed an increasing tendency after operation, Statistical analysis of differences was not statistically significant. The RI value of the two groups of patients changed after the operation. The RI of the renal blood flow detected at 1 hour after operation was significantly increased, and then gradually recovered. The RI of the children group was more obvious than that of the adult group. CONCLUSION: Renal blood flow RI is significantly increased at 1 h after cardiopulmonary bypass, which is more obvious in children than in adults.