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心内直视手术后继发肾功能不全,可以在血尿素氮、肌酐明显升高之前,通过连续测定游离水清除率(free water clearance)及密切观察血液酸硷及气体改变而作出早期诊断。本文研究了用高渗预充液灌注进行心内直视手术的38例成年病人。按其术后血尿素氮升高程度分为两组:肾衰组为术后血尿素氮高于50mg/dl.者共八例;余30例为对照组。分别在体外循环前(麻醉前、诱导麻醉后30分钟),体外循环中(灌注10分钟、60分钟),体外循环后(10分钟、40分钟、2小时、3小时、6小时),手术后(1、2、3日)抽取动脉血作二氧化碳分压(PCO_2)、硷超(BE)及非呼PH(PH_(40)),观察血液气体及酸硷改变。并于相应时间收集尿液测定尿量及渗透压。同时测定血浆渗透
Secondary renal insufficiency following open heart surgery allows early diagnosis of blood urea nitrogen and creatinine by continuous measurement of free water clearance and close observation of changes in blood pH and gas. In this paper, 38 adult patients undergoing open heart surgery with hypertonic priming fluid were studied. According to their postoperative blood urea nitrogen levels are divided into two groups: renal failure group is postoperative blood urea nitrogen higher than 50mg / dl. A total of eight cases; the remaining 30 cases as control group. The patients underwent cardiopulmonary bypass (pre-anesthesia, induction of anesthesia 30 minutes), cardiopulmonary bypass (perfusion 10 minutes, 60 minutes), after cardiopulmonary bypass (10 minutes, 40 minutes, 2 hours, 3 hours, 6 hours) The arterial blood was collected for PCO_2, BE and non-PH (PH_ (40)) on days 1 and 2, and blood gas and pH were observed. And at the appropriate time to collect urine urine and osmotic pressure. Simultaneous determination of plasma penetration