多巴胺对病人体外循环期间肾血流的影响

目的 评价小剂量多巴胺对病人体外循环(CPB)期间肾血流的影响.方法 择期体外循环下行心血管手术病人60例,年龄21～64岁,随机分为2组(n=30):生理盐水对照组(C组)和多巴胺组(D组).麻醉诱导后气管插管,机械通气,分别于首次灌注心脏停搏液后5 min(给药前)及颈内静脉输注多巴胺2/μg·kg-1·min-120min时(给药后)采用经食管超声测定左侧肾动脉内径及血流速度,计算左肾血流量和肾动脉阻力.结果 与C组比较,D组给药后肾动脉血流速度及血流量增加,肾动脉阻力下降(P<0.05),肾动脉内径差异无统计学意义(P0.05).结论 CPB中静脉输注小剂量多巴胺可增加肾大血流量.

Effects of dopamine on renal blood flow during cardiopulmonary bypass

Objective To investigate the effects of dopamine on renal blood flow during eardiopulmonary bypass (CPB). Methods Sixty ASA Ⅱ or Ⅲpatients with normal renal function aged 21-64 yr weighing 50-78 kg scheduled for elective cardiovascular surgery under CPB were randomized into 2 groups (n=30 each):Ⅰ control group (C) and Ⅱ dopamine group (D) received low dose dopamine infusion (at 2 μg·kg-1·min-1) for 20 min during CPB. The internal diameter of left renal artery and renal blood flow velocity were measured by transesophageal echocardiography before and after dopamine infusion and renal blood flow volume and renal artery resistance were calculated. Results Renal blood flow velocity and renal blood flow volume were significantly increased and renal artery resistance was significant decreased after 20 min low-dose dopamine infusion as compared with the values before dopamine infusion and rend blood flow velocity and renal blood flow volume were significantly higher and renal artery resistance was lower in group D than in group C. There was no significant difference in the internal diameter of renal artery between the 2 groups. Conclusion Ⅳ infusion of small dose dopamine can increase renal blood flow volume during CPB.