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目的:观察围手术期持续应用小剂量多巴胺对低血压肾移植患者术后移植肾功能恢复的影响。方法:总共419例肾移植患者,其中48例血压偏低患者自术中开始至术后72h以多巴胺(2～4μg·kg~(-1)·min~(-1))微量泵持续静注。观察患者移植肾血管开放后72h血压变化;术后3d尿量;手术开始前(T_0)、移植术后12h(T_1)、24h(T_2)、48h(T_3)、72h(T_4)、及术后5d(T_5)抽取静脉血检验血肌酐。结果:对比未应用多巴胺肾移植患者,此组病人肾移植术后早期尿量明显高于平均水平。多巴胺组患者术后血肌酐值下降优于对照组。多巴胺组术后发生移植肾功能延迟恢复例数(2/48例,4.2%)明显低于对照组(35/371例,9.4%),P<0.01。结论:肾移植受者围手术期持续应用低剂量多巴胺,能明显促进早期移植肾功能的恢复,并能减少移植肾功能延迟恢复(DGF)的发生率。
OBJECTIVE: To observe the effect of continuous application of small doses of dopamine during perioperative period on postoperative renal graft recovery in patients with hypotension renal transplantation. METHODS: A total of 419 renal transplant recipients, including 48 patients with low blood pressure, were given intravenous infusion of dopamine (2-4μg · kg -1 · min -1) . The changes of blood pressure at 72 hours after the opening of renal graft were observed. The amount of urine was measured before operation (T 0), 12 h (T 1), 24 h (T 2), 48 h (T 3), 72 h Serum creatinine was detected on 5d (T_5) venous blood. Results: Compared with patients without dopamine transplantation, the urine output of these patients after renal transplantation was significantly higher than the average. Postoperative serum creatinine value in the dopamine group was better than that in the control group. Postoperative delayed graft function (2/48 cases, 4.2%) in the dopamine group was significantly lower than that in the control group (35/371 cases, 9.4%), P <0.01. CONCLUSION: Continuous perioperative application of low dose dopamine in renal transplant recipients can significantly promote the recovery of early graft function and reduce the incidence of delayed graft function (DGF).