目的：本研究通过利用彩色多普勒超声技术，探讨体外循环下冠状动脉旁路移植术（CABG）和非体外循环心脏跳动下冠状动脉旁路移植术（OPCAB）术后肾段动脉、肾叶间动脉阻力指数（RI）的改变特点。方法：冠脉搭桥手术患者20例，其中10例行CABG，10例行OPCAB，均于术前麻醉前、术后1 h、4 h、16 h、24 h行彩色多普勒超声检测各时点肾段动脉及肾叶间动脉RI，并同时检测肾功能指标尿素氮（Urea）和肌酐（Crea），最后对所有数据进行统计分析。结果：CABG组患者术后1 h及术后4 h肾段动脉RI与术前相比较明显增高（P＜0.05），肾叶间动脉RI术后1 h、4 h、16 h、24 h与术前相比较均明显增高（P＜0.05）；OPCAB组患者术后各时间点肾段动脉及肾叶间动脉RI与术前相比较均无明显统计学差异；CABG术后1 h、4 h肾段动脉RI较OPCAB组高（P＜0.05），CABG术后肾叶间动脉各时间点RI较OPCAB组高（P＜0.05）；CABG组肾功能指标Crea在术后4 h与术前相比较明显增高（P＜0.05），余指标改变与术前比较差异不具有统计学意义（P＞0.05）。结论：超声能较好的评估冠脉搭桥术后早期患者肾段动脉及肾叶间动脉RI的改变特点；CABG术后早期肾段动脉及肾叶间动脉RI较术前明显增高，CABG术较OPCAB术对肾血流RI改变的影响更明显。
Abstract
Objective: To investigate the resistance index(RI) changes of the renal segmental artery and renal interlobar artery after coronary artery bypass grafting(CABG) and off-pump coronary artery bypass grafting(OPCAB) by ultrasound. Methods: Twenty cases of coronary artery bypass surgery, 10 cases underwent CABG, and 10 cases underwent OPCAB, the RI of the renal segmental artery and renal interlobar artery were detected at 1 h, 4 h, 16 h, 24 h after operation and before anesthesia, and urea nitrogen(Urea) and creatinine(Crea) were detected at the same time. Finally, all data were analyzed statistically. Results: In the CABG group, compared with that before operation, the renal segmental artery RI at 1 h, 4 h after operation were significantly increased(P＜0.05), the renal interlobar artery RI at 1 h, 4 h, 16 h and 24 h after operation were significantly increased(P＜0.05). In the OPCAB group, compared with that before operation, the renal segmental artery and the renal interlobar artery RI at each time point after operation were no significant difference. The renal segmental artery RI at 1 h, 4 h after operation in CABG group was higher than that in OPCAB group(P＜0.05), the renal interlobar artery RI at each time point after operation in CABG group was higher than that in OPCAB group(P＜0.05). In CABG group, the renal function index Crea at 4 h after operation was significantly higher than that before operation(P＜0.05), and the difference of the residual index after operation was not statistically significant compared with that before operation(P>0.05). Conclusions: Ultrasound can evaluate the RI changes of renal segmental artery and renal interlobar artery in early stage after coronary artery bypass surgery, the RI of renal segmental artery and the renal interlobar artery in early stage after CABG are higher than that before operation. The effect of CABG on renal blood flow RI changes is more obvious than that of OPCAB.
关键词
冠状动脉疾病 /
肾动脉 /
血管阻力 /
超声检查 /
多普勒 /
彩色
Key words
Coronary disease /
Renal artery /
Vascular resistance /
Ultrasonography, Doppler, color
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