先天性心脏病体外循环术后合并急性肾损伤患儿的临床特点及预后分析
发布时间：2018-12-23 13:01
【摘要】：目的分析体外循环(CPB)手术后合并急性肾损伤(AKI)的先天性心脏病患儿围术期临床资料,探讨有无改善预后的可调节因素。方法针对小儿先心病CPB手术后48 h内发生AKI的118例患者进行回顾性分析。结果 118例中手术后48 h后死亡的18例。与存活组相比,死亡组术前的紫绀型心脏病所占比例、先天性心脏病手术风险评估共识评分均较高;术中CPB时间和升主动脉阻断时间、采用全晶体液进行心肌保护的比例、术中平均血糖均较高;术后48 h内正性肌力药物分值(IS)、术后肌酐值、3级AKI所占比例、采用肾脏替代疗法进行治疗的比例、红细胞或其它血制品输注数量均较高,差异均具有统计学意义(P0.05)。术后死亡率随着术中平均血糖升高而增加,有线性关联(P0.05)。术中平均血糖8.3 mmol/L的患儿累积生存率和平均生存期均低于血糖≤8.3 mmol/L者(P0.05)。结论先天性心脏病CPB术后合并AKI患儿的术中血糖水平与预后相关,术中严格控制血糖上升对改善CPB术后AKI患儿的预后有积极作用。
[Abstract]:Objective to analyze the perioperative clinical data of children with congenital heart disease complicated with acute renal injury (AKI) after (CPB) operation under cardiopulmonary bypass (CPB), and to explore the possible prognostic factors. Methods 118 children with congenital heart disease who developed AKI within 48 hours after CPB operation were retrospectively analyzed. Results of 118 cases, 18 died 48 hours after operation. Compared with the survival group, the proportion of preoperative cyanotic heart disease in the death group and the consensus score of surgical risk assessment for congenital heart disease were higher. Intraoperative CPB time and ascending aorta occlusion time, total crystal solution for myocardial protection, the average intraoperative blood glucose was higher; Positive creatine score within 48 hours after operation, creatinine value after (IS), the proportion of AKI of grade 3, the proportion of renal replacement therapy, the quantity of red blood cells or other blood products were higher. The difference was statistically significant (P0.05). Postoperative mortality increased with the increase of intraoperative mean blood glucose (P 0.05). The cumulative survival rate and mean survival time of children with intraoperative mean blood glucose 8.3 mmol/L were lower than those with blood glucose 鈮，
本文编号：2390018
[Abstract]:Objective to analyze the perioperative clinical data of children with congenital heart disease complicated with acute renal injury (AKI) after (CPB) operation under cardiopulmonary bypass (CPB), and to explore the possible prognostic factors. Methods 118 children with congenital heart disease who developed AKI within 48 hours after CPB operation were retrospectively analyzed. Results of 118 cases, 18 died 48 hours after operation. Compared with the survival group, the proportion of preoperative cyanotic heart disease in the death group and the consensus score of surgical risk assessment for congenital heart disease were higher. Intraoperative CPB time and ascending aorta occlusion time, total crystal solution for myocardial protection, the average intraoperative blood glucose was higher; Positive creatine score within 48 hours after operation, creatinine value after (IS), the proportion of AKI of grade 3, the proportion of renal replacement therapy, the quantity of red blood cells or other blood products were higher. The difference was statistically significant (P0.05). Postoperative mortality increased with the increase of intraoperative mean blood glucose (P 0.05). The cumulative survival rate and mean survival time of children with intraoperative mean blood glucose 8.3 mmol/L were lower than those with blood glucose 鈮，
本文编号：2390018
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