论文部分内容阅读
目的 观察肾移植病人术后硬膜外自控镇痛（PCEA）对血浆内皮素及肾功能的影响。方法 40例慢性肾功衰竭病人,随机分成PCEA组（P组）和非PCEA组（N组）,每组20例。两组分别于麻醉前、手术后24、48、72h抽取静脉血,采用放射免疫法测定血浆内皮素、尿素氮、肌酐、尿酸浓度。结果 两组病人术后第24h MAP、血浆内皮素、尿素氮、肌酐、尿酸浓度明显下降,于术后第72h均达到各自的最低水平,但N组各时点的测定值明显高于同时点P组的测定值（P<0.01）。内皮素与尿素氮、肌酐、尿酸含量有良好的相关性（r分别为0.76、0.85和0.69,P<0.01）。结论 肾移植病人术后应用PCEA,能有效消除术后刀口痛引起的焦虑、交感神经兴奋导致的少尿,从而加速改善肾功能。
Objective To observe the effect of postoperative epidural analgesia (PCEA) on plasma endothelin and renal function in renal transplant recipients. Methods Forty patients with chronic renal failure were randomly divided into two groups: PCEA group (P group) and non-PCEA group (N group). Venous blood was drawn before anesthesia, at 24, 48 and 72 hours after operation, and plasma endothelin, urea nitrogen, creatinine and uric acid concentrations were measured by radioimmunoassay. Results After 24 h MAP, plasma endothelin, blood urea nitrogen, creatinine and uric acid were significantly decreased in both groups, reaching the lowest level at 72h after operation. However, the measured values at each time point in group N were significantly higher than those at the same time point Group P measured values (P <0.01). Endothelin and urea nitrogen, creatinine, uric acid content has a good correlation (r = 0.76,0.85 and 0.69, P <0.01). Conclusion The application of PCEA after renal transplantation patients can effectively eliminate postoperative pain caused by the knife edge of the anorexia, sympathetic stimulation caused by oliguria, thereby accelerating the improvement of renal function.