CAJ | 학술논문

目的探讨非小细胞肺癌(NSCLC)术后发生急性肾功能不全(ARI)的危险因素.方法回顾性分析2007年1月至2013年10月同济医院胸外科收治的经手术和病理组织学确诊的l 496例NSCLC患者,分为2组,依据肾功能不全的诊断标准从以上病例中筛选33例作为病例组,从剩余病例中筛选721例作为对照组,进行logistic回归分析.结果病例组与对照组在手术年龄、术前肌酐值、术前补液、术中血浆代用品的使用上差异有统计学意义.手术年龄≥60岁和使用血浆代用品发生ARI的风险更高[调整OR为.93(1.30～6.62),95％ CI为6.04(1.41～25.87)].术前补液是发生ARI的保护因素(调整OR为0.37,95％ CI为0.17～0.83).结论 NSCLC术后并发ARI的主要独立危险因素为手术年龄较大(≥60岁)和术中血浆代用品的使用;术前适量补液可降低NSCLC术后ARI的发生率,为其保护因素.
목적 탐토비소세포폐암(NSCLC)술후발생급성신공능불전(ARI)적위험인소.방법 회고성분석2007년1월지2013년10월동제의원흉외과수치적경수술화병리조직학학진적l 496례NSCLC환자,분위2조,의거신공능불전적진단표준종이상병례중사선33례작위병례조,종잉여병례중사선721례작위대조조,진행logistic회귀분석.결과 병례조여대조조재수술년령、술전기항치、술전보액、술중혈장대용품적사용상차이유통계학의의.수술년령≥60세화사용혈장대용품발생ARI적풍험경고[조정OR위.93(1.30～6.62),95％ CI위6.04(1.41～25.87)].술전보액시발생ARI적보호인소(조정OR위0.37,95％ CI위0.17～0.83).결론 NSCLC술후병발ARI적주요독립위험인소위수술년령교대(≥60세)화술중혈장대용품적사용;술전괄량보액가강저NSCLC술후ARI적발생솔,위기보호인소.
Objective To discover the risk factors of acute renal insufficiency(ARI) in perioperative of non-small cell lung cancer(NSCLC).Methods We took a retrospective study to analysis and summarize the clinical features of 33 ARI cases and 721 controls,all subjects were histopathologically confirmed NSCLC from January 2007 to October 2013.Logistic regression analysis was conducted to analyze the association between the risk factors and ARI.Results There were significant differences between the two groups in operation age,level of preoperative creatinine,preoperative rehydration and the use of plasma substitutes.After adjustment by confounding factors,operation age older than 60 years old and the use of plasma substitutes had higher risk of ARI [adjusted OR was 2.93 (1.30-6.62),95 ％ CI was 6.04 (1.41-25.87),respectively].Preoperative rehydration was protective factor of ARI(adjusted OR was 0.37,95％ CI was 0.17-0.83).Conclusion Operation age (≥ 60 years old) and the use of blood substitutes are independent risk factors of ARI,while preoperative rehydration can reduce the incidence of ARI after surgery.