维持性血液透析患者全麻术后并发症分析

发布时间：2019-03-14 17:26

【摘要】：目的探讨维持性血液透析（maintenance hemodialysis，MHD)患者实施全麻手术(不含肾移植)后并发症发生情况及其影响因素。方法收集我院2009年1月至2013年12月54例行维持性血液透析的终末期肾脏病患者因不同病因实施全麻手术的临床资料，并随机选取60例相应科室同期实施全麻手术的肾功能正常患者的临床资料作对照，回顾性分析其术后并发症的发生情况及影响因素。结果与肾功能正常患者比较，，维持性血液透析患者术后并发症发生率显著升高（48.1%和10.0%，P0.01）；最常见并发症为严重高血压（20.4%），其次为肺部感染（14.8%）、心脏事件（13.0%）；与对照组相比住院时间显著延长，分别为（22.37±13.57）天和（10.82±6.09）天（P0.01）；两组术后死亡率无统计学差异（7.4%和1.7%，P=0.188）；原发病为糖尿病肾病、术前低白蛋白血症、术中出血≥400ml与术后并发症增加有关（P均0.05）；多变量Logistic回归分析提示原发病为糖尿病肾病是预测维持性血液透析患者术后并发症出现与否的独立危险因素（OR=17.914，95%可信区间：1.164-275.802；P=0.039）。结论维持性血液透析患者术后住院时间长，并发症发生率高，最常见并发症为严重高血压、肺部感染、心脏事件，其发生与患者术前低白蛋白血症、术中出血多及原发病为糖尿病肾病密切相关，其中原发病为糖尿病肾病是维持性血液透析患者术后出现并发症的独立危险因素。
[Abstract]:Objective To study the complications of maintenance hemodialysis (MHD) after general anesthesia (without renal transplantation) and its influencing factors. Methods The clinical data of the patients with end-stage renal disease of maintenance hemodialysis were collected from January 2009 to December 54,2013, and the clinical data of 60 patients with normal renal function in general anesthesia were randomly selected. The occurrence and effect of postoperative complications were analyzed retrospectively. Results Compared with normal renal function, the incidence of postoperative complications in maintenance hemodialysis patients increased significantly (48.1% and 10.0%, P0.01); the most common complications were serious hypertension (20.4%), followed by pulmonary infection (14.8%) and cardiac event (13. The hospitalization time was significantly prolonged in the control group (22.37-13.57) and (10.82-6.09) days (P0.01). There was no statistical difference between the two groups (7.4% and 1.7%, P = 0.188). The risk factors (OR = 17.914,95% confidence interval: 1.164-275.802; P = 0.0) for predicting the occurrence of postoperative complications in maintenance hemodialysis patients (OR = 17.914,95% CI: 1.164-275.802; P = 0.0) 39) Conclusion Maintenance hemodialysis patients have a long hospital stay and a high complication rate. The most common complications are serious hypertension, pulmonary infection and cardiac events. It is closely related to the disease, in which the former is diabetic nephropathy, which is the only one of the complications after the maintenance hemodialysis patients.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R692.5

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