心脏手术相关性急性肾损伤发病率及其危险因素分析

发布时间：2018-01-05 12:04

  本文关键词：心脏手术相关性急性肾损伤发病率及其危险因素分析　出处：《南京医科大学学报(自然科学版)》2015年12期 　论文类型：期刊论文

  更多相关文章： 心脏手术相关的急性肾损伤 发病率 危险因素

【摘要】：目的 :应用KDIGO标准,评估心脏手术相关性急性肾损伤(cardiac surgery-associated acute kidney injury,CSA-AKI)的发病率及其相关危险因素。方法:回顾性分析南京医科大学附属南京医院2009年1月—2011年12月在体外循环(cardiopulmonary bypass,CPB)下进行心脏手术的1 575例患者的临床特征。采用单因素和多因素logistic回归分析CSA-AKI发生的影响因素。多元Cox比例风险模型评估CSA-AKI对ICU期间病死率和住院期间病死率的影响。结果:1 575例患者中,534例(34%)发生CSA-AKI,22例(1.4%)患者需要肾替代治疗,住院总病死率为1.3%(20/1 575)。CSA-AKI的独立危险因素为机械通气时间(P0.001)、CPB时间≥100 min(P0.01)、输注红细胞(P0.001)、术后3 d内体温超过38℃(P0.05)等,而使用乌司他丁与CSA-AKI低发生率相关(P0.01)。Cox比例风险模型结果显示AKI住院期间死亡风险是非AKI患者的2.26倍(P0.05),而需要肾脏替代治疗患者其死亡风险是非肾脏替代患者的18.65倍(P0.001)。结论:CSA-AKI的发生与机械通气时间、输注红细胞以及术后3 d内体温超过38°C等密切相关。乌司他丁的使用与CSA-AKI低发病率有关。CSA-AKI与住院期间死亡风险显著相关,尤其是接受肾替代治疗的患者。
[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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