心脏外科术后急性肾损伤行日间连续性肾脏替代治疗死亡危险因素分析

发布时间：2018-07-09 13:37

本文选题：肾脏替代治疗 + 心脏外科手术　；参考：《中国实用内科杂志》2017年09期

【摘要】：目的研究心脏术后急性肾损伤(acute kidney injury,AKI)行日间连续性肾脏替代治疗(daytime continuous renal replacement therapy,DCRRT)患者的死亡危险因素,并分析治疗前后各指标的变化。方法回顾性分析中国医科大学附属第一医院2004年6月至2015年9月期间心脏外科收治的心脏术后AKI行DCRRT治疗的42例患者的临床资料、治疗方法、治疗前后的各项指标及死亡危险因素,并进行统计学分析。结果心脏术后AKI行DCRRT患者的病死率为47.6%(20/42)。存活组与死亡组两组低心排血综合征、年龄等比较差异有统计学意义(P0.05),治疗前后心率、肾功能等比较差异有统计学意义(P0.01)。Logistic回归分析显示,首次DCRRT治疗前平均动脉压、血清HCO3-浓度为独立保护性因素。结论 DCRRT治疗后肾功等指标较治疗前有明显改善。DCRRT前平均动脉压、血清HCO3-浓度为心脏术后AKI患者行DCRRT的独立保护性因素。
[Abstract]:Objective to study the risk factors of death in patients with acute renal injury after cardiac surgery (acute kidney injury-AKI) treated with continuous day renal replacement therapy (daytime continuous renal replacement), and to analyze the changes of indexes before and after treatment. Methods the clinical data and treatment methods of 42 patients with AKI treated with DCRRT after cardiac surgery from June 2004 to September 2015 in the first affiliated Hospital of China Medical University were retrospectively analyzed. The indexes and death risk factors before and after treatment were analyzed statistically. Results the mortality of patients with DCRRT was 47.6% (20 / 42). There were significant differences in low cardiac output syndrome and age between the survival group and the death group (P0.05). There were significant differences in heart rate and renal function before and after treatment (P0.01). Logistic regression analysis showed that the mean arterial pressure before the first DCRRT treatment was significant. Serum HCO 3-concentration was an independent protective factor. Conclusion after DCRRT treatment, the mean arterial pressure was significantly improved after DCRRT. Serum HCO _ 3- concentration was an independent protective factor for DCRRT in patients with AKI after cardiac surgery.
【作者单位】：中国医科大学附属第一医院肾内科;滕州市中心人民医院肾内科;
【基金】：国家“十二五”科技支撑计划项目子课题(2011BAI10B02) 辽宁省科技厅社会发展攻关计划(2013225303) 辽宁省教育厅高等学校科研项目(L2011134) 卫生公益性行业科研专项(201502010)
【分类号】：R692.5

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