围手术期急性肾损伤临床特征及预后180例分析

发布时间：2018-05-07 04:33

本文选题：围手术期 + 急性肾损伤　；参考：《中国实用内科杂志》2017年01期

【摘要】：目的探讨围手术期急性肾损伤(AKI)患者的临床特征。方法收集第二军医大学附属长征医院肾内科2011年度手术患者的肾功能指标,根据2012年改善全球肾脏病预后组织(KDIGO)的AKI诊断标准筛选出符合标准的AKI患者,回顾性分析患者的临床资料,分析总结其临床特征。结果 2011年1—12月手术患者共16681例,符合入选标准的围手术期AKI患者共180例,围手术期AKI发生率为1.1%,识别率仅为3.3%,AKI 1~3期患者所占比例分别为63.9%、16.7%和19.4%。构成比最高的科室为泌尿外科,占30%,其次为肝移植科、神经外科、普外科等。所有AKI住院患者中,83.3%的患者好转出院,7.2%死亡,另有9.4%放弃治疗。Logistic回归分析显示,AKI分期、手术时间是患者死亡的危险因素,AKI分期越高,手术时间越长,患者死亡风险越大。结论围手术期AKI在住院患者中较常见,病死率高,识别率较低。年龄增长、疾病严重程度增加可增加围手术期AKI患者的死亡风险。因此,围手术期AKI的早期诊断和治疗对疾病的防治、提高患者生存率和改善预后有积极作用。
[Abstract]:Objective to investigate the clinical features of patients with acute renal injury (AKI) during perioperative period. Methods the renal function indexes of the patients in the Department of Nephrology, Department of Nephrology, affiliated long March Hospital of the second military Medical University were collected. According to the AKI diagnostic criteria for improving the prognosis of global kidney disease in 2012, the patients with AKI were selected. The clinical data and clinical features of the patients were analyzed retrospectively. Results from January to December 2011, there were 16681 patients with AKI. The incidence of perioperative AKI was 1.1. The recognition rate was only 3.3% and 16.7% and 19.4%, respectively. The department with the highest ratio was urology, accounting for 30%, followed by liver transplantation, neurosurgery, general surgery and so on. Among all the inpatients, 83.3% of the patients died from the illness and 7.2% died, and 9.4% of the patients gave up treatment. Logistic regression analysis showed that the time of operation was the risk factor of death. The higher the stage was, the longer the operation time was, the greater the risk of death was. Conclusion perioperative AKI is more common in inpatients with high mortality and low recognition rate. Increasing age and severity may increase the risk of death in perioperative AKI patients. Therefore, the early diagnosis and treatment of perioperative AKI play a positive role in the prevention and treatment of disease, improve the survival rate of patients and improve the prognosis.
【作者单位】：第二军医大学附属长征医院肾内科;
【基金】：国家自然科学基金(81500533)
【分类号】：R699.2

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