| 赵柯超.成人心脏外科术后行连续性肾脏替代治疗的死亡危险因素[J].浙江中西医结合杂志,2022,32(11): |
| 成人心脏外科术后行连续性肾脏替代治疗的死亡危险因素 |
| Risk Factors of Death in Patients Undergoing Continuous Renal Replacement Therapy after Cardiac Surgery |
| 投稿时间：2022-03-24 修订日期：2022-07-08 |
| DOI： |
| 中文关键词: 心脏外科手术 急性肾损伤 连续性肾脏替代治疗 危险因素 |
| 英文关键词:Cardiac surgery Acute kidney injury Continuous renal replacement therapy Risk factor |
| 基金项目:浙江省医药卫生科技计划项目(2020KY273) |
|
| 摘要点击次数: 539 |
| 全文下载次数: 10 |
| 中文摘要: |
| 目的 探讨心脏外科术后行连续性肾脏替代治疗（continuous renal replacement therapy，CRRT）患者的死亡危险因素。方法 回顾性分析2020年1月至2021年9月宁波市医疗中心李惠利医院心脏外科术后接受CRRT治疗的患者45例的临床资料，男31例，女14例，平均年龄 (63.87±12.56) 岁。采用单因素分析和多因素logistic回归分析死亡相关的危险因素。结果 45例心脏术后发生急性肾损伤接受CRRT治疗患者被纳入该研究，其中26例存活，19例死亡，死亡率为42.2%。单因素分析显示术前前白蛋白水平（t=2.343，P=0.025）、术中低血压（X2=11.068，P=0.001）、输血量（t=-2.232，P=0.031）和出血量（t=-2.366，P=0.023）、体外循环时间（t=-2.128，P=0.040）、单瓣膜手术方式（X2=4.555，P=0.033）、术后第一天肌酐水平（t=2.058，P=0.046）、术后出现肺部感染（X2=8.091，P=0.004）和多脏器功能衰竭（X2=9.012，P=0.003）、CRRT持续时间（t=-2.518，P=0.016）、术后体外膜肺氧合支持（X2=6.938，P=0.008）为死亡的危险因素。多因素logistic回归分析显示死亡的独立危险因素有：术中输血量（B=0.001，OR=1.001，P=0.025），术前前白蛋白水平（B=-0.031，OR =0.969，P=0.004），单瓣膜手术方式（B=-2.231，OR =0.107，P=0.037）。结论 术中输血量是心脏术后CRRT 患者死亡的主要危险因素，需加强术中管理。术前前白蛋白水平及单瓣膜手术方式是保护因素，前白蛋白水平越高，手术方式越简单，预后越好。 |
| 英文摘要: |
| Objective To investigate the risk factors for mortality in patients undergoing continuous renal replacement therapy (CRRT) after cardiac surgery. Methods This is a retrospective observational study conducted in 45 patients, consisting of 31 males and 14 females at an average age of (63.87±12.56) years. All patients received CRRT after cardiac surgery in Ningbo Medical Center Li Huili Hospital from January 2020 to September 2021, and univariate analysis, as well as multivariate logistic regression analysis was used to analyze the risk factors associated with mortality. Results Out of 45 patients with acute renal injury after cardiac surgery who received CRRT, 26 survived the treatment while the rest didn’t, with a mortality rate of 42.2%. Univariate analysis showed that risk factors for mortality included preoperative albumin level (t=2.343, P=0.025), intraoperative hypotension (X2=11.068, P=0.001), blood transfusion (t=-2.232, P=0.031) and blood loss (t=-2.366, P=0.023), cardiopulmonary bypass time (t=-2.128, P=0.040), single-valve operation method (X2=4.555, P=0.033), postoperative creatinine level on the first day (t=2.058, P=0.046), postoperative pulmonary infection (X2=8.091, P=0.004), multiple organ failure (X2=9.012, P=0.003), duration of CRRT (t=-2.518，P=0.016) and postoperative extracorporeal membrane oxygenation support(X2=6.938, P=0.008). Through multivariate logistic regression, the independent risk factors for mortality included intraoperative blood transfusion volume (B=0.001, OR=1.001, P=0.025), preoperative albumin level (B =-0.031, OR =0.969, P=0.004) and single-valve surgical method (B =-2.231, OR =0.107, P=0.037). Conclusion Intraoperative blood transfusion is a major risk factor for mortality of CRRT patients after cardiac surgery, and intraoperative management should be strengthened. Preoperative albumin level and single-valve operation were protective factors. The higher the prealbumin level or the simpler the operation method was, the better the prognosis of the disease would be. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
