CAJ | 학술논문

目的评估连续性静脉-静脉血液透析(CVVHD)治疗心脏术后急性肾损伤(AKI)失败的危险因素.方法 2005年1月-2012年12月在同济医院心胸外科因心脏手术后AKI行CVVHD治疗的成年患者分为CVVHD治疗失败组和治疗成功组.回顾性分析患者术前、术中、术后相关临床资料.结果 93例患者被纳入该研究,其中63例治疗成功,30例治疗失败,CVVHD治疗失败率为32.2％,病死率19.4％.通过单因素分析和多因素Logistic回归分析,CVVHD治疗心脏术后AKI失败的独立危险因素有:术前LVEF(OR =0.61,95％ CI0.42～0.85)和从少尿到透析的间隔时间(OR=2.76,95％CI 1.51 ～5.83).结论术前左室受损是CVVHD治疗心脏术后AKI失败的危险因素.CVVHD实施越早,患者预后越好.
목적 평고련속성정맥-정맥혈액투석(CVVHD)치료심장술후급성신손상(AKI)실패적위험인소.방법 2005년1월-2012년12월재동제의원심흉외과인심장수술후AKI행CVVHD치료적성년환자분위CVVHD치료실패조화치료성공조.회고성분석환자술전、술중、술후상관림상자료.결과 93례환자피납입해연구,기중63례치료성공,30례치료실패,CVVHD치료실패솔위32.2％,병사솔19.4％.통과단인소분석화다인소Logistic회귀분석,CVVHD치료심장술후AKI실패적독립위험인소유:술전LVEF(OR =0.61,95％ CI0.42～0.85)화종소뇨도투석적간격시간(OR=2.76,95％CI 1.51 ～5.83).결론 술전좌실수손시CVVHD치료심장술후AKI실패적위험인소.CVVHD실시월조,환자예후월호.
Objective To evaluate the independent risk factors for failure of continuous venovenous hemodialysis (CVVHD) in the treatment of acute kidney injury (AKI) following cardiac surgery.Methods Adult patients without any prior pre-operative history of chronic renal disease suffering AKI following cardiac surgery and undergoing CWHD at our center from January 2005 to December 2012 were recruited and divided into either a success group or a failure group.All pre-,intra-and post-operative data were collected and retrospectively analyzed.Results Ninety-three adult patients were enrolled.Among them,sixty-three patients survived with a failure rate of 32.2％ and a mortality rate of 19.4％.Through univafiate analysis and multivariate Logistic regression,independent risk factors for failure of CVVHD in the treatment of post-operative AKI included pre-operative LVEF (OR =0.61,95％ CI O.42-0.85) and duration of oliguria until dialysis (OR =2.76,95％ CI 1.51-5.83).Conclusion Pre-operative impaired left ventricular function is an important risk factor for failure of CVVHD in the treatment of AKI after cardiac surgery.The sooner the implementation of CVVHD,the better prognosis.