经颈静脉肝内门体分流术中对比剂使用量与术后发生急性肾功能损伤风险的分析

发布时间：2018-04-29 23:17

本文选题：急性肾损伤 + 肝硬化　；参考：《中国介入影像与治疗学》2016年02期

【摘要】：目的评估经颈静脉肝内门体分流术(TIPS)术后发生急性肾功能损伤(AKI)的相关风险因素。方法回顾性分析在我院接受TIPS术治疗的1 630例患者的年龄、性别等一般临床资料及对比剂用量、手术前后肾功能与AKI发生的关系。结果 1 630例患者接受TIPS,15.95%(260/1 630)发生AKI,表现为术后48h血清肌酐较术前上升26.50μmol/L。通过校正分析发现,静脉注射对比剂量每增加50ml,AKI发生风险增加27%(95%CI 1.01~1.60,P=0.04)。术前血清肌酐每增加8.8μmol/L,术后AKI发生风险增加17%(95%CI 1.04~1.31,P=0.008)。对于有潜在肾功能受损的患者,静脉注射对比剂每增加50 ml,AKI的发生风险增加63%(95%CI 1.20~2.31,P=0.003)。结论TIPS术中静脉注射对比剂用量与术后AKI发生的风险有关,尤其对于合并有肾功能损伤的患者。
[Abstract]:Objective to evaluate the risk factors of acute renal function injury (AKI) after intrahepatic portosystemic shunt (TIPS). Methods the clinical data of 1 630 patients who were treated with TIPS in our hospital were analyzed retrospectively. The relationship between renal function and AKI before and after operation was analyzed. Results AKI occurred in 1 630 patients who received TIPS15. 95 and 260 / 1 630). The manifestations of AKI were that the serum creatinine increased 26.50 渭 mol / L at 48 hours after operation compared with that before operation. The results of calibration analysis showed that the risk of occurrence of 27%(95%CI was increased with 50 ml of contrast dose, and the risk was increased by 1.01 ~ (-1) ~ 1.60 ~ (-1) 27%(95%CI / L ~ (0.04) 路L ~ (-1). Preoperative serum creatinine levels increased by 8.8 渭 mol / L, and the risk of postoperative AKI was increased by 1.04 渭 mol / L, 1.31 渭 mol / L and 0.008 渭 mol / L, respectively. In patients with potentially impaired renal function, the risk of 63%(95%CI 1.20 / 2.31g / kg / 50ml / kg / kg / kg / kg / ml / kg / kg / kg / kg / kg / kg / kg / ml / kg / kg / kg / kg / kg / L / L group. Conclusion the dosage of intravenous contrast agent during TIPS is associated with the risk of postoperative AKI, especially in patients with renal function injury.
【作者单位】：中国人民解放军第535医院介入科;贵州医科大学附属医院介入科;
【基金】：贵州省科技计划基金项目(黔科合SY字[2012]3145号)
【分类号】：R575.2

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