АНАЛИЗ ФУНКЦИИ ПОЧЕК ПОСЛЕ ON-PUMP И OFF-PUMP АОРТОКОРОНАРНОГО ШУНТИРОВАНИЯ

Кардиопульмонарное шунтирование (CPB) часто ассоциируется с дисфункцией почек, как следует из анализа уровней креатинина в плазме и уровней гемодиализа.

Цель. Сравнить клиренс креатинина (CrCl), рассчитанного по формуле Кокрофта-Голта, у пациентов, перенесших off-pump коронарное шунтирование (OPCAB) и on-pump коронарное шунтирование (on-CAB).

Материал и методы. В период с апреля 2008 г. по апрель 2009 г., 119 пациентов, были подвергнуты коронарному шунтированию. Пятьдесят восемь (58) из этих пациентов прошли OPCAB, в то время как 61 — (onCAB). Клиренс креатинина, уровень креатинина плазмы, и клинические результаты сравнивались между группами. Значение клиренса креатинина 50 мл/мин было принято в качестве минимального предела нормальной функции почек.

Результаты. Были два смертельных случая в больнице, вызванных сепсисом после легочной инфекции. Клиренс креатинина (предоперационная OPCAB 73,64±33,72 x on-CAB 75,70±34,30мл/мин; постоперационная величина OPCAB 75,73±35,07 x on-CAB 79,07±34,71 мл/мин; p=0,609) и уровни креатинина (предоперационная OPCAB 1,04±0,38 x on-CAB 1,13±0,53 мг/дл; постоперационное значение OPCAB 1,12±0,79 x on-CAB 1,04±0,29mg/дл; р=0,407) не имеют статистических различий между группами.

Заключение. Ухудшение функции почек ассоциируется с более высокой частотой послеоперационных осложнений. Существенной разницы в значениях уровня креатинина, не может быть продемонстрировано между группами.

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