严重心功能不全伴有肾功能损害患者的体外循环

目的总结严重心功能不全伴有肾功能损害患者的体外循环灌注的经验。方法22例患者在体外循环中采用改变预充方案，保证足够的灌注流量，维持较高的灌注压，慎用对肾毒性药物，进行血液保护和减轻炎性反应，同时应用超滤和利尿药帮助滤出水分，防止对肾功能进一步损伤。结果1例患者因术后发生严重的低心排，泵衰竭而行血液透析，其余均恢复良好。结论严重心功能不全伴有肾功能损害患者在术中加强各方面的保护措施，防止对肾脏产生进一步损伤，基本上均可平安渡过手术。

The Cardiopulmonary Bypass for Severe Cardiac Insufficiency with Impairment of Renal Function

OBJECTIVE To study the extracorporeal perfusion method for severe cardiac insufficiency with impairment of renal function. METHODS 22 patients were used modified priming solution , kept enough perfusion flowrate and high perfusion perssure,avoid renal toxic drugs, blood preserving and to reduce inflammatory response, also ultrafiltration and diuretics can be used at the same time to prevent renal function worse. RESULTS Only one case need hemodialysis because of lower cardiac output and renal failure ,other patients all recovered smoothly. CONCLUSION If used many protection way in operations of patients with severe cardiac insufficiency with impairment of renal function, to prevent renal function worse , good results can be obtained in most patients .