中国体外循环杂志
中國體外循環雜誌
중국체외순배잡지
Chinese Journal of Extracorporeal Circulation
2015年
3期
161-164
,共4页
尚蔚%马敏%张巍%阮彩霞%刘楠%孙立忠%侯晓彤
尚蔚%馬敏%張巍%阮綵霞%劉楠%孫立忠%侯曉彤
상위%마민%장외%원채하%류남%손립충%후효동
急性主动脉夹层%Cleveland评分%急性肾损伤%肾脏替代治疗
急性主動脈夾層%Cleveland評分%急性腎損傷%腎髒替代治療
급성주동맥협층%Cleveland평분%급성신손상%신장체대치료
Acute aortic dissection surgery%Cleveland values%Acute kidney injury%Renal replacement treatment
目的：研究深低温停循环的急性主动脉夹层孙氏术后急性肾损伤（ AKI ）发生率，探讨影响AKI进展的相关因素，建立合理的术前风险评估系统和预防策略。方法2009年2月至2013年8月在本院行急诊主动脉夹层孙氏手术的400例患者。计算术前肾小球滤过率和Cleveland评分，记录术中深低温停循环情况。术后发生AKI伤150例，根据有无肾脏替代治疗，分AKI未进展组（ n＝118）和AKI进展组（ n＝32）。对两组临床资料进行单因素和多因素比较，分析影响AKI进展的相关因素。结果急诊主动脉夹层孙氏术后AKI发生率37．5％（150／400）。其中21．3％（32／150）的AKI需要肾脏替代治疗。两组性别、年龄和手术类型无差异；AKI进展组术前肾小球滤过率明显降低，高血压病史、Cleveland评分、体外循环和主动脉阻断时间明显比未进展组增高。多因素Logistic回归分析显示高血压病史、Cleveland评分和主动脉阻断时间影响AKI的进展，预测术后肾脏替代治疗的风险。结论高血压、Cleveland评分和主动脉阻断时间影响术后AKI进展，需要肾脏替代治疗。
目的：研究深低溫停循環的急性主動脈夾層孫氏術後急性腎損傷（ AKI ）髮生率，探討影響AKI進展的相關因素，建立閤理的術前風險評估繫統和預防策略。方法2009年2月至2013年8月在本院行急診主動脈夾層孫氏手術的400例患者。計算術前腎小毬濾過率和Cleveland評分，記錄術中深低溫停循環情況。術後髮生AKI傷150例，根據有無腎髒替代治療，分AKI未進展組（ n＝118）和AKI進展組（ n＝32）。對兩組臨床資料進行單因素和多因素比較，分析影響AKI進展的相關因素。結果急診主動脈夾層孫氏術後AKI髮生率37．5％（150／400）。其中21．3％（32／150）的AKI需要腎髒替代治療。兩組性彆、年齡和手術類型無差異；AKI進展組術前腎小毬濾過率明顯降低，高血壓病史、Cleveland評分、體外循環和主動脈阻斷時間明顯比未進展組增高。多因素Logistic迴歸分析顯示高血壓病史、Cleveland評分和主動脈阻斷時間影響AKI的進展，預測術後腎髒替代治療的風險。結論高血壓、Cleveland評分和主動脈阻斷時間影響術後AKI進展，需要腎髒替代治療。
목적：연구심저온정순배적급성주동맥협층손씨술후급성신손상（ AKI ）발생솔，탐토영향AKI진전적상관인소，건립합리적술전풍험평고계통화예방책략。방법2009년2월지2013년8월재본원행급진주동맥협층손씨수술적400례환자。계산술전신소구려과솔화Cleveland평분，기록술중심저온정순배정황。술후발생AKI상150례，근거유무신장체대치료，분AKI미진전조（ n＝118）화AKI진전조（ n＝32）。대량조림상자료진행단인소화다인소비교，분석영향AKI진전적상관인소。결과급진주동맥협층손씨술후AKI발생솔37．5％（150／400）。기중21．3％（32／150）적AKI수요신장체대치료。량조성별、년령화수술류형무차이；AKI진전조술전신소구려과솔명현강저，고혈압병사、Cleveland평분、체외순배화주동맥조단시간명현비미진전조증고。다인소Logistic회귀분석현시고혈압병사、Cleveland평분화주동맥조단시간영향AKI적진전，예측술후신장체대치료적풍험。결론고혈압、Cleveland평분화주동맥조단시간영향술후AKI진전，수요신장체대치료。
Objective This study aims to analyze the independent risk factors associated with advanced acute kidney injury ( AKI) after acute aortic dissection surgery. Methods Clinical data of the patients who underwent acute aortic dissection surgery from February 2009 to August 2013 were collected. Data including preoperative GFR, Cleveland values and intraoperative CPB time were gathered. The patients were divided to two groups of acute kidney injury with renal replacement treatment ( RRT) and without renal re?placement treatment. Results 400 patients underwent aortic surgeries from February 2009 to August 2013. Acute kidney injury oc?curred in 150(150/400, 37.5%) patients, including 118 patients without RRT and 32 patients with RRT. The GFR was significant lower and the history of hypertension, Cleveland value and the time of aortic clamp were significant higher inRRT group. Multivariate Logistic regression analysis showed hypertension, Cleveland value and the time of aortic clamp were associated with advancement of a?cute kidney injury. Conclusion Hypertension, Cleveland value and the time of aortic clamp were associated with more advanced acute kidney injury.
