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目的探讨主动脉夹层腔内隔绝术后肾功能的变化。方法对40例在全身麻醉和控制性降压下施行经股动脉覆膜支架介入治疗术。麻醉采用异丙酚和芬太尼为主的全凭静脉麻醉,持续监测心电图,连续桡动脉测压,脉搏血氧饱和度,以硝酸甘油控制术中收缩压在90～120mmHg,在释放支架时将收缩压控制在70～90mmHg。术毕及时建立术后镇痛。抽血化验动态监测术前和术后5天内肾功能。结果Bun和Ua手术前后无明显差异,术后5天内患者肾功能各指标无明显差异。术后4天内肾功能指标Cera与术前肾功能比较存在显著性差异,第5天恢复到术前水平。结论控制性降压易实施,对肾功能影响较小。
Objective To investigate the changes of renal function after endovascular exclusion of aortic dissection. Methods Forty cases underwent transcatheter stent-graft intervention under general anesthesia and controlled hypotension. Anesthesia with propofol and fentanyl-based total intravenous anesthesia, continuous monitoring of ECG, continuous radial artery manometry, pulse oximetry, nitroglycerin control systolic blood pressure at 90 ~ 120mmHg, when the stent is released Systolic blood pressure control in 70 ~ 90mmHg. Complete postoperative pain relief in time. Blood tests Dynamic monitoring of renal function within 5 days before and after surgery. Results There was no significant difference between Bun and Ua before and after operation. There was no significant difference in each index of renal function within 5 days after operation. Within 4 days after operation, the renal function index Cera was significantly different from preoperative renal function, and returned to the preoperative level on the 5th day. Conclusion Controlled hypotension is easy to implement and has little effect on renal function.