心血管外科术后急性肾功能衰竭的处理

目的：总结两组心血管外科术后急性肾功能衰竭病例的治疗经验，提出心血管外科术后急性肾功能衰竭的特点、早期诊断标准及处理原则。方法：１７例心血管外科术后急性肾功能衰竭病例，以入院先后分为两组。第１组８例，第２组９例。回顾第１组病例的急性肾功能衰竭的治疗经验，总结腹膜透析、血液透析和血液滤过的优缺点。在第２组病例治疗中，以急性肾功能衰竭的早期诊断为前题，早期开始腹膜透析。同时，强调综合治疗的重要性。结果：第１组病例均死亡。第２组病例，７例存活（７８％）。结论：心血管外科术后急性肾功能衰竭的早期诊断和早期肾功能替代疗法，是治疗成败的关键。腹膜透析简便易行，在急性肾功能衰竭的早期开始腹膜透析，可以收到良好效果，并以此作为心血管外科术后急性肾功能衰竭的首选肾功能替代疗法。

Management of Acute Renal Failure After Cardiovascular Surgical Operation

Objective:To summarize the therapeutic experience of cardiovascular patients with post operative acute renal failure(ARF) for giving the characteristics,the early dignostic criteria,the monitoring index and the principles of prevention and management of ARF. Methods:Seventeen cases of cardiovascular patients with post operative ARF were separated into two groups according to the chrnological order.The therapeutic experience of the first group( n =8)was reviewed,the advantages and disadvantage of peritoneal dialysis,hemodilysis and hemofiltration were compared.In the 2nd group( n =9),an early peritoneal dialysis was performed as the early dignosis had been made.The importance of combined treatment was also emphasized. Results:All patients died in the first group,7 out of 9 patients(78%) survived in the second group. Conclusion:The key to the successful management of cardiovascular patients with post operative ARF lies in the early diagnosis and early subsititutive treatment of renal function.The peritoneal dialysis is easy to perform and gives a good effect if treated early.It is suggested that the early peritoneal dialysis is the first choice of the substitutive treatment of renal function in cardiovascular patients with post operative ARF.