围术期血气监测与家兔肾移植预后的关系

实用器官移植电子杂志 ›› 2018, Vol. 6 ›› Issue (1): 30-33.

围术期血气监测与家兔肾移植预后的关系

薛帅 1 ，钟自彪 1 ，兰佳男 1 ，胡前超 1 ，向涛 1 ，熊艳 1 ，王彦峰 1 ，叶啟发 1， 2

出版日期:2018-01-20 发布日期:2021-06-24

Correlation of blood gas finding and prognosis in rabbit kidney transplantation

Online:2018-01-20 Published:2021-06-24

摘要/Abstract

摘要：

目的探究家兔肾移植围术期静脉血气值与家兔肾移植预后的关系。方法应用家兔在体肾脏低温机械灌注（HMP）方式建立家兔自体肾移植模型。根据血气分析分为 A 组和 B 组，A 组为术中血气值维持在正常范围内，B 组为术中血气值下降。术中术后统计每只家兔静脉血气值变化情况，分析术后家兔生存率、24 小时后肌酐、尿量与家兔血气值变化情况的相关性。结果根据家兔术中血气值变化情况分为两组，A 组家兔 6 只灌注过程中家兔血气值基本保持不变，B 组家兔 8 只在灌注过程中 pH 呈下降趋势（7.40±0.02 比 7.05±0.08，P ＜ 0.001），碱剩余值（BE 值）与 HCO3 - 明显下降〔BE ：-1.00±1.58 比 -9.42±1.89，P ＜ 0.001 ；HCO3 - （mmol/L）：20.34±1.11 比 14.68±1.44，P ＜ 0.05）〕。与 A 组家兔相比， B 组家兔术后生存率明显下降（83.3% 比 62.5%，P ＜ 0.05），24 小时后肌酐、尿素氮明显升高〔肌酐（μmol/L）： 342.00±18.81 比 518.00±23.54，P ＜ 0.001 ；尿素氮（mmol/L）9.20±2.01 比 23.40±3.33 mol/L，P ＜ 0.05〕，尿量明显降低（116.80±6.55 ml/d 比 75.20±6.94 ml/d，P ＜ 0.05）。结论家兔机械灌注过程中血气值的稳定与家兔肾移植预后有一定的相关性，血气值稳定的家兔预后较好，酸中毒家兔其生存率及肾功能均欠佳。因此，在机械灌注过程中有必要采取一定干预措施保持家兔内环境的稳定性。

Abstract:

Objective To clear the relationship between perioperative venous blood gas results and prognoses of rabbit kidney transplantation. Methods The rabbit autologous kidney transplantation models were established using a rabbit hypothermic machine perfusion. Results Rabbits were grouped，according to changes of blood gas values. The blood gas values of rabbits in group A were unchanged during perfusion. The pH values of blood samples in group B were decreased during the perfusion（7.40±0.023 vs. 7.05±0.08，P ＜ 0.001）. Compared with group A，the BE and HCO3 - values of group B were significantly decreased〔BE ：-1.00±1.58 vs. -9.42±1.89， P ＜ 0.001 ；HCO3 - （mmol/L）：20.34±1.11 vs. 14.68±1.44，P ＜ 0.05〕. The survival rate of group B was significantly lower than that of group A（62.5% vs. 83.3%，P ＜ 0.05）. In group B，the urine outputs were significantly lower after reperfusion（ml/d ：116.80±6.55 vs.75.20±6.94，P ＜ 0.05）and the creatinine and urea nitrogen were significantly increased〔creatinine（umol/L）：342.00±18.81 vs. 518.00±23.54，P ＜ 0.001 ；urea nitrogen（mmol/L）：9.20±2.01 vs. 23.40±3.33，P ＜ 0.05）〕. Conclusion The stability of blood gas in rabbitsduring mechanical perfusion has some correlation with the prognosis of rabbit kidney transplantation. Therefore， during the process of hypothermic machine perfusion，specific managements should be given to maintain the stability of the internal environment of the rabbit.

薛帅, 钟自彪, 兰佳男, 胡前超, 向涛, 熊艳, 王彦峰, 叶啟发, . 围术期血气监测与家兔肾移植预后的关系[J/CD]. 实用器官移植电子杂志, 2018, 6(1): 30-33.