發(fā)布時間：2018-01-05 12:04

  本文關(guān)鍵詞：心臟手術(shù)相關(guān)性急性腎損傷發(fā)病率及其危險因素分析　出處：《南京醫(yī)科大學(xué)學(xué)報(自然科學(xué)版)》2015年12期 　論文類型：期刊論文

  更多相關(guān)文章： 心臟手術(shù)相關(guān)的急性腎損傷 發(fā)病率 危險因素

【摘要】：目的 :應(yīng)用KDIGO標(biāo)準(zhǔn),評估心臟手術(shù)相關(guān)性急性腎損傷(cardiac surgery-associated acute kidney injury,CSA-AKI)的發(fā)病率及其相關(guān)危險因素。方法:回顧性分析南京醫(yī)科大學(xué)附屬南京醫(yī)院2009年1月—2011年12月在體外循環(huán)(cardiopulmonary bypass,CPB)下進(jìn)行心臟手術(shù)的1 575例患者的臨床特征。采用單因素和多因素logistic回歸分析CSA-AKI發(fā)生的影響因素。多元Cox比例風(fēng)險模型評估CSA-AKI對ICU期間病死率和住院期間病死率的影響。結(jié)果:1 575例患者中,534例(34%)發(fā)生CSA-AKI,22例(1.4%)患者需要腎替代治療,住院總病死率為1.3%(20/1 575)。CSA-AKI的獨(dú)立危險因素為機(jī)械通氣時間(P0.001)、CPB時間≥100 min(P0.01)、輸注紅細(xì)胞(P0.001)、術(shù)后3 d內(nèi)體溫超過38℃(P0.05)等,而使用烏司他丁與CSA-AKI低發(fā)生率相關(guān)(P0.01)。Cox比例風(fēng)險模型結(jié)果顯示AKI住院期間死亡風(fēng)險是非AKI患者的2.26倍(P0.05),而需要腎臟替代治療患者其死亡風(fēng)險是非腎臟替代患者的18.65倍(P0.001)。結(jié)論:CSA-AKI的發(fā)生與機(jī)械通氣時間、輸注紅細(xì)胞以及術(shù)后3 d內(nèi)體溫超過38°C等密切相關(guān)。烏司他丁的使用與CSA-AKI低發(fā)病率有關(guān)。CSA-AKI與住院期間死亡風(fēng)險顯著相關(guān),尤其是接受腎替代治療的患者。
[Abstract]:Objective: to apply KDIGO standard. To evaluate cardiac surgery-associated acute kidney injury in patients with cardiac surgery associated with acute renal injury. The incidence of CSA-AKI and its related risk factors. Methods: the incidence of CSA-AKI and its related risk factors were analyzed retrospectively during the period from January 2009 to December 2011 in Nanjing Hospital of Nanjing Medical University. Cardiopulmonary bypass. CPB). For cardiac surgery. The clinical features of 575 patients were analyzed by univariate and multivariate logistic regression analysis. Multivariate Cox proportional risk model to evaluate the effect of CSA-AKI on I. Effects of CU mortality and hospitalization mortality. Results:. In 1 575 patients. Renal replacement therapy was needed in 534 patients with CSA-AKI (22 patients with CSA-AKI disease). The independent risk factor of the total inpatient mortality of 1.3R / 1 575U 路CSA-AKI was mechanical ventilation time (P 0.001). The CPB time was more than 100min (P0.01A, P0.001A), and the body temperature exceeded 38 鈩，

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