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老年髋部骨折术后发生急性肾损伤的临床特点及危险因素分析
引用本文:张琳丽,麻晓红. 老年髋部骨折术后发生急性肾损伤的临床特点及危险因素分析[J]. 临床荟萃, 2021, 36(5): 442-445. DOI: 10.3969/j.issn.1004-583X.2021.05.011
作者姓名:张琳丽  麻晓红
作者单位:深圳平乐骨伤科医院(深圳市坪山区中医院)老年骨科,广东深圳518118;北京大学深圳医院胸外科,广东深圳518036
摘    要:目的 探讨老年髋部骨折术后发生急性肾损伤(AKI)的临床特点及危险因素分析.方法 髋部骨折手术患者470例,根据AKI的诊断标准将患者分为非AKI组(276例)和AKI组(194例).检测两组白细胞(WBC)、红细胞(RBC)、血肌酐(SCr)、血尿素氮(BUN)、白蛋白(ALB)、肾小球滤过率(eGFR)、血红蛋白(...

关 键 词:急性肾损伤  骨折术后  预后
收稿时间:2020-12-05

Clinical features and risk factors of acute kidney injury after hip fracture in the elderly
Zhang Linli,Ma Xiaohong. Clinical features and risk factors of acute kidney injury after hip fracture in the elderly[J]. Clinical Focus, 2021, 36(5): 442-445. DOI: 10.3969/j.issn.1004-583X.2021.05.011
Authors:Zhang Linli  Ma Xiaohong
Affiliation:1. Department of Orthopaedics, Shenzhen Pingle Orthopedic and Traumatology Hospital(Shenzhen Pingshan Hospital of Traditional Chinese Medicine), Shenzhen 518118, China2. Department of Thoracic Surgery, Shenzhen Hospital, Peking University, Shenzhen 518036, China
Abstract:Objective To investigate clinical characteristics and risk factors of acute kidney injury(AKI) after hip fracture in the elderly. Methods Four hundred and seventy patients undergoing hip fracture surgeries were selected. According to the criteria for acute kidney injury, the patients were divided into non-AKI group (276 cases) and AKI group (194 cases). The white blood cells (WBC), red blood cells (RBC), serum creatinine (SCr), blood urea nitrogen (BUN), albumin (ALB), glomerular filtration rate (eGFR), hemoglobin (Hb) indicators, acid-base balance (pH), partial pressure of arterial oxygen (PaO2), partial pressure of arterial carbon dioxide (PaCO2), bicarbonate radical (HCO3), serum potassium (K+), serum calcium (Ca2+) indicators were detected between the two groups, and related prognostic risk factors were analyzed. Results Coronary heart disease, diabetes, hypotension, the index of WBC, ALB. GFR in the two groups were statistically significant difference (P<0.05). Compared the non-AIK group, the operation duration, intraoperative blood loss, and anesthesia duration in AKI group were significantly higher (P<0.05). SCr, BUN and length of length of hospitalization in AKI group were significantly higher (P<0.05). 24-hour urine output in AKI group were significantly lower (P<0.05). pH, HCOs and K+ in AKI group were significantly higher (P<0.05). PaO2, PaCO2, and Ca2+ of AKI group were significantly lower (P<0.05). The coronary heart disease, diabetes, hypotension, WBC, ALLB and eGFR, length of Length of hospitalization were independent risk factors for AKI in hip surgery in elderly patients (P<0.05). Conclusion If the elderly patients have underlying diseases involving coronary heart disease, diabetes, and hypotension before hip fracture surgeries, they would have a higher risk of post-operative AKI. The treatment for such elderly patients become more difficult and increase the risk of death which will have an impact on the prognosis recovery.
Keywords:acute kidney injury  post-operative hip fracture surgery  prognostic  
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