| Japanese |
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| Title | 未透析腎不全患者に対する開心術周術期管理の検討 |
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| Subtitle | 原著 |
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| Authors | 堀部まゆみ*, 右田貴子*, 望月高明**, 羽生道弥** |
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| Organization | *あかね会土谷総合病院麻酔科, **あかね会土谷総合病院心臓血管外科 |
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| Journal | 循環制御 |
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| Volume | 16 |
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| Number | 2 |
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| Page | 218-222 |
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| Year/Month | 1995/ |
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| Article | 原著 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 「要旨」未透析腎不全患者の開心術では水・電解質の管理, BUN・Cr是正, 残腎機能の保護などの問題を有している. Ccr30ml/分未満または血清クレアチニン値1.8mg/dl以上の予定開心術13例を対象に, 周面期管理について検討を加えた. 体外循環中は限外濾過を行った. 体外循環中の尿量は3.6±3.3ml/kg/時間, 術中総尿量・バランスは4.0±1.9ml/kg/時間, +3.4±3.2ml/kg/時間で, 腎機能の良好な群に比較して有意にプラスバランスで経過した. 術後BUNの上昇は遷延したが, 血清クレアチニンは術後3日目には術前値に復した. 電解質異常, アシドーシスの進行はなく透析を要した症例もなかった. 腎機能低下例の開心術においては水分バランスの管理に細心の注意を要し, 腎血流減少にもとづく腎障害の進行を回避し, 心機能を加味した至適輸液量の決定が必要である. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | Open heart surgery, Chronic renal failure, ECUM, Perioperative management |
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| English |
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| Title | Perioperative Management of Open Heart Surgery in Non-dialysis Patients with Chronic Renal failure |
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| Subtitle | |
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| Authors | Mayumi Horibe, Takako Migita, Takaaki Mochizuki, Michiya Hanyu |
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| Authors(kana) | |
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| Organization | Department of Anesthesia and Cardiovascular Surgery Akane-kai Tsuchiya General Hospital |
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| Journal | Circulation Control |
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| Volume | 16 |
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| Number | 2 |
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| Page | 218-222 |
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| Year/Month | 1995/ |
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| Article | Original article |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | This study was done on 13 non-dialysis patients with chronic renal failure who underwent elective open heart surgery (CRF group) comparing with 16 patients with normal renal function (control group). We employed extracorporeal ultrafiltration during cardiopulmonary bypass for regulating water balance, electrolytes and acid-base balance. Intraoperative urine output (4.0 ± 1.9 ml/kg/hour) of CRF group was less than that of control group and positive water balance (+3.4±3.2 ml/kg/hour) was significantly higher in CRF group. Inereased blood urea nitrogen of CRF group lasted until the 7 postoperative day and increased serum creatinine recovered to the preoperative level within three days in the group. No patient required hemodialysis during the postoperative course. We conclude that we should pay particular attention to adequate fluid administration during and after surgery to avoid renal impairment due to low renal blood flow. |
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| Practice | Basic medicine |
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| Keywords | Open heart surgery, Chronic renal failure, ECUM, Perioperative management |
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