重度肾功能损害患者行不停跳冠脉搭桥术后持续肾脏替代治疗影响因素分析
发布时间：2018-11-28 09:32
【摘要】：目的探讨重度肾功能损害患者行非体外循环冠状动脉旁路移植术(off-pump coronary artery bypass grafting,OPCABG)术后应用持续肾脏替代治疗(continuous renal replacement therapy,CRRT)的术前独立危险因素。方法访问首都医科大学附属北京安贞医院麻醉科OPCABG围术期数据库,收集2012年2月至2016年7月术前血清肌酐(Cr)重度升高(血清Cr值≥正常值1.5倍)患者行OPCABG的临床资料,统计术后CRRT发生情况,采用Logistic回归分析CRRT的术前独立危险因素。结果共纳入45例患者,术后应用CRRT有9例(20%)。与非CRRT患者比较,CRRT患者术前血清Cr和尿素氮(BUN)浓度明显升高,术中尿量明显减少,术后12、24h血清Cr浓度明显升高,术后ICU时间明显延长,院内死亡率明显升高(P0.05或P0.01)。Logistic回归分析显示,术前血清Cr浓度升高为术后CRRT的独立危险因素(OR=1.05,95%CI 1.05~1.10,P=0.046)。当术后12h血清Cr浓度166μmol/L时,每升高1μmol/L,术后CRRT治疗率增加5%(OR=1.05,95%CI 1.01~1.08,P=0.013),但在血清Cr浓度350μmol/L时,达到封顶效应。结论术前血清Cr重度升高患者OPCABG术后CRRT治疗率为20%,而术前血清Cr浓度升高是OPCABG患者术后CRRT的独立危险因素。
[Abstract]:Objective to investigate the preoperative independent risk factors of continuous renal replacement therapy (continuous renal replacement therapy,CRRT) after off-pump coronary artery bypass grafting (off-pump coronary artery bypass grafting,OPCABG) in patients with severe renal dysfunction. Methods the perioperative OPCABG database of Anzhen Hospital affiliated to Capital Medical University was used to collect the clinical data of patients with severe elevation of serum creatinine (Cr) (serum Cr 鈮，
本文编号：2362471
[Abstract]:Objective to investigate the preoperative independent risk factors of continuous renal replacement therapy (continuous renal replacement therapy,CRRT) after off-pump coronary artery bypass grafting (off-pump coronary artery bypass grafting,OPCABG) in patients with severe renal dysfunction. Methods the perioperative OPCABG database of Anzhen Hospital affiliated to Capital Medical University was used to collect the clinical data of patients with severe elevation of serum creatinine (Cr) (serum Cr 鈮，
本文编号：2362471
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