Dissertation > Excellent graduate degree dissertation topics show

Comparative Analysis of Volume Regimens for Homogeneity Variant Kidney Transplantation

Author: CuiYaZuo
Tutor: ZhangTieZuo
School: Dalian Medical University
Course: Anesthesiology
Keywords: Kidney transplantation Anesthesia Volume therapy
CLC: R614
Type: Master's thesis
Year: 2009
Downloads: 17
Quote: 0
Read: Download Dissertation

Abstract


Objective: comparative analysis of renal transplantation in three different rehydration on hemodynamics and postoperative outcome in patients undergoing to looking for the better kidney transplantation capacity treatment strategies meaningful clinical data. Methods: A retrospective analysis of the General Hospital of Shenyang Military Region October 1997 to November 2007, 1051 patients undergoing kidney transplantation. A total of 255 cases, cases that met the inclusion criteria ASA Ⅱ ~~ Ⅲ grade, male 167 cases, 88 females, aged 16 to 67 years old, weighing 31 ~ 95kg. Patients were divided into 3 groups according to the intraoperative infusion of the kind of liquid, Group: A the colloid group of (Crystals blood Dingan red blood albumin); group B: the crystal red blood cell group; C group: crystal group. Analysis of indicators: 1. GENERAL INFORMATION: gender, age, weight and operation time. Perioperative information: ⑴ hemodynamic parameters: SBP, DBP, HR (time point using T0: before anesthesia, T1: start of surgery, T2: vessel occlusion instantly, and T3: 10 min after vascular occlusion, T4 : loop open instantly T5: loop open after 10min, T6: the end of surgery). ⑵. Intraoperative fluid intake and output to urine. Into the amount including the amount blocked blood vessels, blocking blood vessels to cycle open intake and circulation open amount. Different types of liquid intake were recorded. Out the amount of urine output and blood loss. (3) using the frequency number and the amount of dopamine in the surgery. ⑷. Intraoperative and postoperative 24h within complications (heart failure, pulmonary edema) incidence. ⑸. Postoperative 24h, 48h, 72h and 7d urine output. ⑹. Laboratory data: ① routine blood test: preoperative and postoperative 24h Hb, Hct. ② electrolyte: preoperative and 24h after the K, Na, CL-. (3) renal function: preoperative and postoperative 24h, 48h, 72h, 7d urea nitrogen (BUN), creatinine (CR). ④ urine routine: preoperative and postoperative 24h urine protein (PRO), specific gravity (SG). 3 postoperative follow-up data: including postoperative ICU stay time the stitches time, postoperative hospital stay, postoperative adjuvant dialysis rate and 1-year survival rate of renal transplantation. Statistical analysis: application SPSS13.0 statistical software analysis, measurement data were expressed as mean ± standard deviation (x ± s) said. First homogeneity of variance test comparison between groups using one-way ANOVA. Count data applications chi-square test (Chi-Square test), comparative analysis group vasoactive drugs utilization rate, intraoperative and postoperative complications (heart failure, pulmonary edema) the incidence of postoperative adjuvant dialysis rate and renal transplantation 1 year survival. P lt; 0.05 was considered significant meaning P lt; 0.01 for the difference was significant. Results: The three groups of patients age, sex, height, weight, and operation time difference was not statistically significant (P gt; 0.05). 2. Hemodynamic parameters among the three groups SBP difference was not statistically significant at all time points. A group of DBP at T0, T1 time was significantly lower than in group C (P lt; 0.05). Three groups of HR in the loop before opening the difference was not statistically significant (T6) C group the HR significantly faster in group A and group B (P lt; 0.05) in the loop open 10min (T5) after the end of surgery. 3 intraoperative fluid intake and output to urine blocking differences in fluid intake in the blood vessels between the first three groups was not statistically significant (P gt; 0.05). Blocking the blood vessels to open loop between Group A fluid intake significantly more than the B group (P lt; 0.05) and C group (P lt; 0.01). A group of former open loop fluid intake significantly more than the B group (P lt; 0.05) and group C (P lt; 0.01). B, C there was no significant difference. Total liquid intake: A group was significantly more than B and C the two groups (P lt; 0.01), B group significantly more than group C (P lt; 0.01). Saline intake: A group was significantly less than in group B and group C (P lt; 0.01), B group was significantly less than in group C (P lt; 0.01). Balanced fluid intake: A group was significantly greater than in group B and group C (P lt; 0.01), B group was significantly greater than that in group C (P lt; 0.01). The RBC intake: A group was significantly greater than in group B (P lt; 0.01). Blood loss: A group was significantly more than the B and C group (P lt; 0.01), B, C between the two groups, no significant difference. Urine output: no significant difference between the three groups (P gt; 0.05). Urine to time: Compared with group A, group B and group C was significantly shorter (P lt; 0.01), B, C between the two groups, no significant difference (P gt; 0.05). 4. Auxiliary medication dosage dopamine in the three groups of patients: C group was significantly greater than in group A and group B (P lt; 0.05). Dopamine use the frequency of the three groups, but no significant differences (P gt; 0.05). Postoperative urine output after two days of group B urine output significantly more than the A, C two groups (P lt; 0.05); 3 days after the group B urine output was significantly more than group C (P lt; 0.05). 6. Blood and electrolyte changes the Hb before surgery in group A was significantly less than in group B and C group (P lt; 0.05), group B was significantly less than in group C (P lt; 0.05); the postoperative group A significantly smaller than B group C (P lt; 0.05), no statistically significant difference between the group B and group C. Hct preoperative group A was significantly lower than that in group B and group C (P lt; 0.05); postoperative group A was significantly lower than that in group B (P lt; 0.05) between the other two groups had no statistical difference (P gt; 0.05 ). The three groups of patients with preoperative electrolytes (Na, K, Cl-) There was no significant difference (P gt; 0.05), postoperative 24hNa A, B two groups was significantly lower than that in group C (P lt; 0.05). Compared with group A, B, C two sets of Cl-was significantly higher than that in group A (P lt; 0.05). Group 7. Complications of heart failure, pulmonary edema incidence was no significant difference (P gt; 0.05). 8. Renal function in three groups of patients with preoperative renal function (BUN, Cr) no significant difference. 2 days after surgery compared with group C, group B BUN, Cr significantly lower (P lt; 0.05); 3 days after the A and B group BUN, Cr was significantly lower than that in group C (P lt; 0.05); postoperative 7 days Cr was significantly lower than that of group B, group C (P lt; 0.05). 9. Urine routine preoperative and postoperative 24h urine protein (PRO), specific gravity (SG), the differences among the three groups without statistical significance (P gt; 0.05). 10 patients were followed up after surgery ICU days Group A was significantly longer than that in group B (P lt; 0.05). Group A and Group C of postoperative hospital stay was significantly longer than that of group B (P lt; 0.05). Rate of postoperative adjuvant dialysis and renal transplantation 1-year survival rate among the three groups showed no significant difference (P gt; 0.05). Conclusion: 1. Renal transplantation infusion of crystalloid fluid contribute to renal protection, but expansion of the effectiveness of weak, short duration, is not conducive to maintaining intraoperative hemodynamic stability, and could easily lead to electrolyte imbalance prolong postoperative hospital time. Kidney transplantation, infusion of crystalloid solution should be mainly to balance fluid. The crystal liquid colloidal liquid and conducive intraoperative hemodynamic stability, but the protective effect of graft function no advantage. Mainly to balance the liquid, if necessary, blood transfusions, can maintain stable hemodynamics and internal environment conducive postoperative outcomes, may be the optimum capacity of the kidney transplant surgery treatment strategies.

Related Dissertations

  1. Cryopreservation and Transportation for Portunus Pelagicus, Soft Shell Crab and Spawning Crab,S968.252
  2. The Protective Effect of Ambroxol on Children Lung Injury during Cardiopulmonary Bypass,R726.1
  3. Remifentanil and isoflurane on liver function in patients with hepatocellular carcinoma Comparison,R614
  4. Domestic isoflurane inhalation anesthesia effect depends on learning and memory in adult rats related research,R965
  5. Effect of Different Serum Levels of Tacrolimus to Transplant-Renal Doppler Resistance Indices,R699.2
  6. Rat model of chronic allograft nephropathy in GSK3β expression and pathological significance,R692
  7. Sevoflurane and propofol respectively for induction of general anesthesia effect and incidence of adverse events in the meta-analysis,R614
  8. Clinical Efficacy of Waist Shu Points Anesthesia with Intravenous Anesthesia in Hemorrhoids Surgery,R614
  9. Clinical Pharmacokinetics of Sufentanil in Patients Undergoing Kidney Transplantation,R614
  10. Clinical Research of GV2 (Yaoshu) Anesthesia Uniting Traditional Chinese Acupuncture Anesthesia in the Operation of Mixed Hemorrhoid,R269
  11. Contrast-enhanced Ultrasonography in Diagnosis of Early Kidney Allograft Dysfunction after Transplantation,R699
  12. Effect Analysis of Elder Donors in Living Kidney Transplantation,R699.2
  13. The Clinical Observation of Hand-assisted Laparoscopic Donor Nephrectomy,R699.2
  14. Comparision of the Sedative Effects of Dexmedetomidine Supplement with Propofol on Patients under Combined Spinal Epidural Anesthesia,R614
  15. The Research of Social Support and Quality of Life for Kidney Transplantation Recipients,R699
  16. The Tracking Study in the Tibet Miniature Pig of Bone Marrow Stromal Cells Labeled with Superparamagnetic Iron Oxide in Vivo,R329
  17. Identification and Evaluation of Proteins Related to Renal Acute Allograft Rejection,R699
  18. Correlation between Human Leukocyte Antigen and Post-transplantation Drug-induced Liver Injury of Han Population in Hunan Province,R699
  19. Uremic patients KIR, HLA-Cw polymorphism analysis and KIR-HLA-Cw matching and acute renal transplant rejection in,R692.5
  20. Study on Clinical Anesthesia for Shumianning, A New Compound Anesthetic in Cats,S858.293
  21. Effects of Tiletamine and Its Compound Preparation (XFM) on the Neurotransmitter Contents in Different Encephalic Region in Rats,Q95-33

CLC: > Medicine, health > Surgery > Surgical operation > Anesthesiology
© 2012 www.DissertationTopic.Net  Mobile