再次心脏瓣膜置换术后急性肾功能衰竭的危险因素分析

发布时间：2018-06-01 17:38

本文选题：再次瓣膜置换 + 肾功能衰竭　；参考：《临床心血管病杂志》2016年02期

【摘要】：目的:探讨再次心脏瓣膜置换术后急性肾功能衰竭发生的危险因素。方法:回顾272例再次心脏瓣膜置换术患者的临床基本情况、术前肾功能、手术方式、体外循环参数等相关临床资料,通过多因素Logistic回顾分析术后发生急性肾功能损伤的危险因素。结果:272例患者中术后发生急性肾功能衰竭12例。多因素logistic回归分析显示术前合并其他系统疾病(OR=9.104,P=0.029)、急诊手术(OR=90.998,P=0.000)、女性患者(OR=46.449,P=0.016)、术前左心室内径60mm(OR=0.114,P=0.041)是导致患者术后急性肾功能衰竭发生的危险因素。结论:急性肾功能衰竭是再次心脏瓣膜术后最危险的并发症之一,术前积极治疗患者其他系统疾病、选择合理的手术时机,术中尽量缩短体外循环转流时间,术后加强对患者肾功能变化的监测有助于降低肾功能衰竭的发生率。
[Abstract]:Objective: to investigate the risk factors of acute renal failure after valve replacement. Methods: the clinical data of 272 patients undergoing cardiac valve replacement were reviewed, including renal function before operation, operation mode, parameters of cardiopulmonary bypass, and so on. The risk factors of acute renal function injury after operation were analyzed retrospectively by multivariate Logistic. Results 12 cases of acute renal failure occurred after operation in 272 cases. Multivariate logistic regression analysis showed that the risk factors of postoperative acute renal failure were OR9.104 P0.029, emergency operation 90.998P0. 000, female patients 46.449 P0.016, preoperative left ventricular diameter 60mm or 0.114 P0.041), multivariate logistic regression analysis showed that the risk factors of acute renal failure were preoperatively combined with other systemic diseases (OR9.104), emergency operation (90.998U), female patients (46.449), preoperative left ventricular internal diameter (60mm) and left ventricular internal diameter (60mm) were the risk factors of postoperative acute renal failure (ARF). Conclusion: acute renal failure is one of the most dangerous complications after heart valve reoperation. Strengthening the monitoring of renal function after operation can reduce the incidence of renal failure.
【作者单位】：第三军医大学新桥医院心血管外科;
【分类号】：R654.2;R692.5

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