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主动脉夹层术后早期急性肾损伤的危险因素分析 被引量:2

Analysis of risk factor of acute kidney injury in early stage after aortic dissection surgery
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摘要 目的探讨主动脉夹层手术后早期发生急性肾损伤的围术期危险因素。方法回顾性收集2006年1月-2013年6月在本院心血管外科接受主动脉夹层手术的104例患者的临床资料,根据KDIGO分级诊断标准将患者分为急性肾损伤组和非急性肾损伤组,采用Logistic多因素回归分析术后发生急性肾损伤的危险因素。结果术后48 h内发生急性肾损伤78例(75.0%),12例(11.5%)术后需肾替代治疗,住院死亡5例(4.8%)。Logistic回归分析提示:体外循环时间、高血压和深低温停循环时间>40 min是主动脉夹层术后发生急性肾损伤的独立危险因素。结论主动脉夹层术后急性肾损伤的发生概率高。体外循环时间、高血压和深低温停循环时间>40 min是主动脉夹层术后发生急性肾损伤的独立危险因素。 Objective To explore the risk factors of acute kidney injury in early stage after aortic dissection surgery. Methods Clinical data of 104 patients who underwent aortic dissection surgery admitted to our hospital from January 2006 to June 2013 were retrospectively analyzed. The patients were divided into two groups (AKI group and Non-AKI group) according to the KDIGO definition criteria and perioperative variables were analyzed in both groups. The risk factors of acute kidney injury were evaluated by multivariate logistic regression analysis. Results AKI occurred in 78 patients (75.0%) within early 48 hours postoperatively, 12 patients (11.5%) received renal replacement therapy and 5 patients (4.8%) died in hospital. The logistic regression analysis revealed that hypertension, cardiopulmonary bypass time and deep hypothermic circulatory arrest time over 40 minutes were the independent risk factors of acute kidney injury in early stage after aortic dissection surgery. Conclusion AKI is a very common complication after aortic dissection surgery. Hypertension, cardiopulmonary bypass time and deep hypothermic circulatory arrest time over 40 minutes are the independent risk factor of acute kidney injury in early stage after aortic dissection surgery.
出处 《解放军医学院学报》 CAS 2014年第7期692-695,共4页 Academic Journal of Chinese PLA Medical School
关键词 主动脉夹层 急性肾损伤 深低温停循环 危险因素 aortic dissection acute kidney injury deep hypothermic circulatory arrest risk factors
作者简介 王肇,男,在读硕士。研究方向:心血管外科。Email:sophmood@126.com 通信作者:高长青,男,主任医师,教授,博士生导师。Email:gaochq301@yahoo.com
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  • 1Chertow GM, Burdick E, Honour M, et al. Acute kidney injury, mortality, length of stay, and costs in hospitalized patients [ J ] . J Am Soe Nephrol, 2005, 16 ( 11 ) : 3365-3370.
  • 2Kuitunen A, Vento A, Suojaranta-Ylinen R, et al. Acute renal failure after cardiac surgery : evaluation of the RIFLE classification [ J ]. Ann Thorac Surg, 2006, 81 ( 2 ) : 542-546.
  • 3Chertow GM, Levy EM, Hammermeister KE, et at. Independent association between acute renal failure and mortality following cardiac surgery [ J ] . Am J Med, 1998, 104 ( 4 ) : 343-348.
  • 4Hobson CE, Yavas S, Segal MS, et al. Acute kidney injury is associated with increased long-term mortality after eardiothoracic surgery [ J ] . Circulation, 2009, 119 ( 18 ) : 2444-2453.
  • 5Brown JR, Cochran RP, MacKenzie TA, et al. Long-term survival after eardiae surgery is predicted hy estimated glomerular filtration rate [ J ] . Ann Thorac Surg, 2008, 86 ( 1 ) : 4-11.
  • 6Brown JR, Kramer RS, Coca SG, et al. Duration of acute kidney injury impacts long-term survival after cardiac surgery [ J ] . Ann Thorac Surg, 2010, 90 (4): 1142-1148.
  • 7Improving Global Outcomes ( KDIGO ) acute kidney injury work group. KDIGO clinical practice guideline for acute kidney injury [ J ]. Kidney Int Suppl, 2012, 2 ( 1 ) : 1-138.
  • 8Mariscalco G, Lorusso R, Dominici C, et al. Acute kidney injury : a relevant complication after cardiac surgery [ J ] . Ann Thorac Surg, 2011, 92 (4) : 1539-1547.
  • 9Roh GU, Lee JW, Nam SB, et al. Incidence and risk factors of acute kidney injury after thoracic aortic surgery for acute dissection [ J ]. Ann Thorac Surg, 2012, 94 ( 3 ) : 766-771.
  • 10Englbergcr L, Suri RM, Greason KL, et al. Deep hypothermic circulatory arrest is not a risk factor for acute kidney injury in thoracic aortic surgery [ J ] . J Thorac Cardiovasc Surg, 2011 , 141 ( 2 ) : 552-558.

同被引文献24

  • 1Tolwani A. Continuous renal-replacement therapy for acute kidney injury[J]. New England Journal of Medicine,2012,367(26):2505-14.
  • 2Di Eusanio M,Trimarchi S,Patel HJ,et al. Clinical presentation, management, and short-term outcome of patients with type A acute dissection complicated by mesenteric malperfusion: observations from the International Registry of Acute Aortic Dissection[J]. The Journal of thoracic and cardiovascular surgery,2013,145 (2):385-90.
  • 3James M,Bouchard J,Ho J,et al. Canadian Society of Nephrology commentary on the 2012 KDIGO clinical practice guideline for acute kidney injury[J]. American Journal of Kidney Diseases,2013,61(5): 673-85.
  • 4Bragadottir G,Redfors B,Ricksten SE. Mannitol increases renal blood flow and maintains filtration fraction and oxygenation in postoperative acute kidney injury: a prospective interventional study[j]. Crit Care, 2012,16(4):R159.
  • 5Hao Z,Zhi-Wei W,Zhen Z,et al. Endovascular stent-graft placement or open surgery for the treatment of acute type B aortic dissection: a meta-analysis[J]. Annals of vascular surgery,2012,26(4):454-61.
  • 6Chao CT,Lin YF,Tsai HB,et al. Acute kidney injury network staging in geriatric postoperative acute kidney injury patients: shortcomings and improvements[J]. Journal of the American College of Surgeons, 2013,217(2):240-50.
  • 7Roh GU,Lee JW,Nam B,et al. Incidence and risk factors of acute kidney injury after thoracic aortic surgery for acute dissection[J]. The Annals of thoracic surgery,2012,94(3):766-71.
  • 8霍春颖.Stanford A型主动脉夹层术后多器官功能障碍患者的护理[J].护理学杂志,2012,27(12):34-36. 被引量:7
  • 9宋先荣,韩雪萍.Stanford A型主动脉夹层术后急性肾损伤的影响因素[J].中华胸心血管外科杂志,2012,28(10):603-604. 被引量:7
  • 10叶楠,张燕,程虹,谌贻璞.成人心外科手术后急性肾损伤的评分预警系统创建[J].中国胸心血管外科临床杂志,2013,20(4):396-401. 被引量:15

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